Double optic disc – differentiating between true and pseudo-duplication

True optic disc duplication has two optic discs with a double optic nerve. Pseudo-doubling of the optic disc has two discs with only a single optic nerve. We, hereby, report a rare case of optic disc pseudo-duplication associated with proliferative diabetic retinopathy (PDR). A diabetic male patient in his early 50s presented with decreased vision for six months. Visual acuity was 20/200 in the right eye and 20/60 in the left eye. Fundus examination showed PDR changes in both eyes. The right eye revealed the presence of a pseudo-disc superonasal to the optic disc in the nasal midperiphery. Fluorescein angiography revealed that the pseudo-papilla derived its blood supply from the ciliary circulation in addition to a communicating vessel from the central retinal circulation. Ultrasound B scan showed a single optic nerve head shadow. Perimetry showed an additional blind spot with a contiguous inferior arcuate scotoma in the right eye.