A 57-year-old man with relapsing-remitting MS had blurred vision in the left eye for 1 week. Four weeks prior, he started treatment with oral fingolimod, 0.5 mg/d, for progressive MS refractory to interferon beta-1b, intramuscular interferon beta-1a, and glatiramer acetate. At the request of his neurologist, 5 days prior to initiating fingolimod treatment, he had an eye examination and time-domain OCT of his optic nerves and maculas (Figure 4A), which were normal in each eye. One month after starting fingolimod, visual acuity was 20/20 OD and 20/30 OS, from 20/20 OU prior. Dilated examination showed CME in the left eye (the right eye was normal). Time-domain OCT confirmed CME in the left eye with central foveal thickness of 452 μm and an incidental new epiretinal membrane (Figure 4B). The neurologist stopped fingolimod treatment and the patient began treatment with topical bromfenac twice daily in the left eye. One month after discontinuing fingolimod treatment, visual acuity was 20/25 OS. This visit was at a different office, where SD-OCT showed epiretinal membrane and central foveal thickness of 341 μm in the left eye (Figure 4C). Three months after discontinuing fingolimod treatment, visual acuity was 20/25 OS and the blurred vision had resolved. Findings on SD-OCT showed epiretinal membrane and central foveal thickness of 348 μm in the left eye (Figure 4D).