A 28 year old male presented with 1 month history of decreased vision in both eyes. No history of headache, vomiting, trauma. Best Corrected Visual Acuity of right eye was 1.18 LogMAR which was deteriorated to 1.48 LogMAR and left eye was 1.48 LogMAR. Indirect Ophthalmoscopy revealed bilateral optic disc edema with left eye asteroid hyalosis. Fundus Fluorescein Angiography showed hyper-fluorescent leakage at the optic discs . Systemic steroids administered but the visual acuity didn’t improve. Neurological signs were absent. Neuroimaging showed neither abnormal signals nor signs of raised Intra-cranial tension. Primary optic neuropathy causes were ruled out. Magnetic Resonance Venography was performed which showed chronic dural venous sinus thrombosis. Neurophysician opinion taken, titrated on drug Warfarin. In cases with bilateral optic disc edema without neurological signs, complete ophthalmological and neurological evaluation should be done to avoid delayed diagnosis and treatment.
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