ABSTRACT Introduction: Optic perineuritis (PNO) is a rare inflammatory disorder that affects the optic nerve sheath, the cause of which may be idiopathic, infectious and/or autoimmune. The age of presentation is between 40 and 60 years, more frequently in women and with unilateral involvement, with bilateral presentation being exceptional. Case presentation: 82-year-old patient referred by an outpatient ophthalmology clinic to a hospital institution in the city of Medellín, Colombia, with a diagnostic impression of ischemic optic neuropathy due to clinical symptoms for 12 days with binocular horizontal diplopia, left frontotemporal headache of mild intensity and alterations in bilateral visual acuity. During her stay, she required help for diagnosis such as contrast-enhanced nuclear magnetic resonance imaging of the brain and orbit, which showed classic signs of bilateral optic perineur...