Leber hereditary optic neuropathy Leber hereditary optic neuropathy. A 19-year-old man described the sudden onset of blurred vision in his right eye, which continued to progressively worsen. Two months after the onset of visual loss in his right eye, the vision in the left eye declined rapidly. Leber hereditary optic neuropathy (LHON) was confirmed with the identification of a mitochondrial DNA mutation at position 3460. (A) Optic discs, 2 months after onset of visual loss in the right eye, just before symptoms began in the left eye. Minimal temporal pallor of the right optic disc is present. The left optic disc is hyperemic, with subtle peripapillary telangiectatic vessels present. (B) Left optic disc, 3 months after presentation, after both eyes are affected. The disc hyperemia and telangiectasia have resolved, with mild temporal pallor now present. (C) Goldmann visual fields demonstrate bilateral cecocentral scotomas. Source: Optic Nerve Disorders, Practical Neuroophthalmology Citation: Martin TJ, Corbett JJ. Practical Neuroophthalmology; 2013 Available at: https://neurology.mhmedical.com/DownloadImage.aspx?image=/data/books/1041/martin_ch4_fig35.jpeg&sec=59022771&BookID=1041&ChapterSecID=59021899&imagename= Accessed: December 22, 2017 Copyright © 2017 McGraw-Hill Education. All rights reserved