Ischemic optic neuropathy (ION) is a common disease that can cause a loss of visual acuity in the elderly. We treated ION patients with stellate ganglion block (SGB) and investigated its effects on picture visual evoked potential (P-VEP) and blood flow in the ophthalmic artery (OA) and internal carotid artery (ICA). Twelve ischemic eyes in 12 patients diagnosed by the same ophthalmologist were investigated in this study. All patients were treated with daily SGB on the affected side with 2-3 mL of 2% lidocaine for a treatment period of 10-15 days. In ION eyes before SGB, compared with healthy eyes, the latency of P-VEP P(100) was delayed (123 +/- 14 ms versus 98 +/- 3 ms; P < 0.05), and the amplitude was reduced (4.24 +/- 1.76 microV versus 10.26 +/- 4.09 microV; P < 0.05). After SGB, the latency and amplitude returned to normal (103 +/- 6 ms versus 98 +/- 3 ms; 10.43 +/- 4.88 microV versus 10.26 +/- 4.09 microV; P > 0.05). Before treatment, the blood flow velocities of the OA and the ICA on the ischemic side were slow and the resistance indexes were high, but SGB reduced these changes. SGB did not affect the OA and the ICA on the healthy side. We conclude that SGB improves P-VEP and OA and ICA blood flow in ION eyes. Further studies are needed to confirm that this is an effective method for the treatment of ION.