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Backgrond Tumour-necrosis factor alpha (TNF-α) inhibitors are used to treat autoimmune conditions including inflammatory arthritis, inflammatory bowel disease and uveitis. Optic neuritis is a rare but known complication of TNF-α therapy but cases associated with Golimumab are rare.Case A 37-year-old female presented with 1-month history of left eye pain and visual blurring. History was significant for ankylosing spondylitis on treatment for two years with Golimumab. Examination demonstrated reduced visual acuity in the left eye without other cranial nerve or long tract signs. MRI subsequently demonstrated high signal in optic nerves bilaterally with no other demyelinating lesions elsewhere in the CNS. CSF and serum analysis excluded multiple sclerosis, neuromyeltis optica and MOG antibody disease. Golimumab was ceased and the patient was treated with intravenous corticosteroids with oral wean, with limited recovery in visual acuity.Conclusion Optic neuritis is a rare but serious side effect associated with TNF-α inhibitors. Golimumab, a human monoclonal antibody, has fewer cases in the literature describing this complication. There are only two published case reports of optic neuritis secondary to Golimumab immunosuppression.