On examination, his visual acuity without correction was 20/20 OU. Intraocular pressure was 16 mmHg OD and 17 mmHg OS. He had no relative afferent pupillary defect. Slitlamp biomicroscopy disclosed a well-healed corneal ablation zone in each eye. Ophthalmoscopy revealed bilateral optic nerve swelling, with a cup-disc ratio of 0.1 OU (Figure 1).Automated static perimetry disclosed bilateral inferior altitudinal visual field defects (Figure 2). His blood pressure at that time (118/70 mmHg) was unchanged in comparison with his blood pressure prior to the initiation of timolol (114/70 mmHg). Findings on magnetic resonance imaging of the brain and orbits with contrast and lumbar puncture, including opening pressure, were normal. Results of laboratory evaluation including prothrombin time, partial thromboplastin time, international normalized ratio (for anticoagulant monitoring), protein C and S, viscosity, factor V Leiden, homocysteine levels, antithrombin III activity, anticardiolipin and lupus anticoagulant, erythrocyte sedimentation rate, C-reactive protein, antinuclear antibody, rapid plasma reagin, microhemagglutination-Trepona pallidum, Lyme antibody, complete blood cell count, and angiotensin-converting enzyme, were normal. A low positive antibody titer of Bartonella henselae and B quintana (immunoglobulin G, 1:64; immunoglobulin M, <1:20 for each antibody) by enzyme-linked immunosorbent assay was not confirmed by the more clinically validated immunofluorescent assay.