Pseudo-Foster Kennedy Syndrome is described as unilateral optic disc swelling with contra lateral optic atrophy in the absence of an intracranial mass causing compression of the optic nerve. This occurs typically due to bilateral sequential optic neuritis or ischemic optic neuropathy. We describe a case of pseudo-Foster Kennedy Syndrome in a 37-year-old male with unilateral papilledema secondary to malignant hypertension and pre-existing ischemic optic neuropathy in other eye preventing transmission of raised intracranial pressure to the optic nerve. Hypertension and diabetes mellitus (DM) play a significant role in pathogenesis of ischemic optic neuropathy. There is a greater correlation in patients with small disc and little to no cupping. The disorder commonly occurs in the 40-65 yrs age group. Our case is an example of Pseudo-Foster Kennedy syndrome where papilledema in one eye was associated with uncontrolled hypertension and disc pallor in fellow eye was secondary to ischemic optic neuropathy.
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