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A 61-year-old man developed progressive bilateral visual loss over 2 years. He had previously undergone bilateral cataract surgery, without visual improvement. Neuro-ophthalmologic examination identified a best-corrected visual acuity of 6/24 in the right eye and 6/6 in the left eye. Funduscopy showed temporal pallor of the left optic disc. Optical coherence tomography (OCT) (Cirrus Lumera 700, Carl Zeiss Meditec, Dublin, California, USA) showed diffuse retinal nerve fibre layer and ganglion cell layer thinning, and automated perimetry (30:2 Octopus, Haag-Streit Diagnostics, Berna, Swiss) identified an incongruent bitemporal hemianopia, suggesting optic chiasm compression.