Churg-Strauss vasculitis presenting with severe visual loss due to bilateral sequential optic neuropathy

A 44-year-old man with severe visual loss due to an acute bilateral sequential optic neuropathy is described, where the associated pulmonary disease and peripheral eosinophilia led to a diagnosis of Churg-Strauss syndrome (allergic angiitis). The mechanism of the optic neuropathy was most probably acute ischaemia of the anterior optic nerve due to direct involvement of the short posterior ciliary arteries by inflammatory disease of the vessel wall.