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A 62-year-old man presented with blurry vision, tinnitus, hearing loss and mild headache of gradual onset over a month. He had a history of hypertension. On examination, he had decreased left eye visual acuity (20/50) and a left relative afferent pupillary defect. There was no dyschromatopsia, but he had mild pain with extraocular movements. Visual field testing found no obvious field cuts.