Bilateral optic neuropathy due to amiodarone with recurrence

Patients on amiodarone have an increased incidence of optic neuropathy. The unusual case is reported of a 67-year-old man who developed bilateral optic neuropathy 4 weeks after commencing amiodarone and then had unilateral recurrence of segmental disc swelling despite cessation. The case highlights amiodarone-induced optic neuropathy as a different clinical entity to anterior ischaemic optic neuropathy. It is characterized by insidious onset, bilateral disease and protracted disc swelling progressing to optic atrophy. Patients that experience any visual disturbance while taking amiodarone should seek urgent ophthalmic review.