Cogan syndrome mainly affects young adults but can appear from ages 3 to 40 years. Slightly more males are affected than females. The etiology is unknown, but in approximately 20% of cases, the onset is preceded by an upper respiratory infection. In 41% of cases, the eye is affected first; in 43%, the ear is affected first; and in 16% of cases, both organs are affected at the same time. The interval between ocular and ear involvement can be as short as 3 months in the typical syndrome or as long as 11 years in the atypical syndrome. Making the diagnosis of Cogan syndrome is important, not only because vision can be lost, but also because 10% of cases are complicated with aortic insufficiency, which can be life threatening.4 Polyarthralgias or arthritis can also accompany the disease.