This study reviews the visual outcomes of ten patients under the age of 18 years with craniopharyngioma. The paper also reviews the correlation between visual field (VF) testing and optical coherence tomography (OCT) examination and evaluates the role of OCT for the prediction of visual outcomes after surgery. All children underwent surgery for the removal of the tumour with one child also receiving adjuvant radiotherapy. To date, the children have required between one and four procedures to control the tumour (mean of two procedures per child). The best kappa concordance coefficients between VF and OCT parameters of atrophy were obtained for the ganglion cell (GC) thickness and the mean retinal nerve fibre layer (RNFL) thickness. The agreement between GC colour maps and VF defects were good. In conclusion, optic nerve compression may be detected by RNFL measurement and GC analysis, and this may be useful in the prediction of visual recovery. It could also be used in the evaluation of uncooperative patients to predict visual damage.