Wegener granulomatosis presenting as bilateral loss of vision

We describe a man presenting with bilateral loss of vision secondary to a branch retinal artery occlusion and ischemic optic neuropathy, in turn related to underlying Wegener granulomatosis (WG). This case is unusual, because the simultaneous development of branch retinal artery occlusion and anterior ischemic optic neuropathy has, to our knowledge, not been reported in WG. Furthermore, only rarely does WG cause bilateral vision loss. The patient responded to immunosuppressive therapy and recovered sufficient vision to resume his vocation as a farmer.