TM is an 8-year-old boy who had undergone strabismus surgery for esotropia and was also treated with glasses and patching for amblyopia. He had responded over 6 months to treatment with improvement to the 20/30 level of vision in the amblyopic right eye. However, on the next 3-month appointment he had dropped the visual acuity in that eye to 20/40-2. His ophthalmologist felt this was unusual with his parents’ careful adherence to the glasses and patching regimen. A careful examination of the optic nerve was performed and early disc pallor was noted that had not been previously observed.
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