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Ocular side effects of intranasal cocaine use are rare but can include corneal epithelial changes, retinal vascular complications, and orbital inflammation.1 This case report describes a 54-year-old Black female who was a habitual cocaine user and presented with acute, painless vision loss of the right eye and right optic disc edema. Cocaine’s sympathomimetic properties can lead to optic neuropathy; therefore, a patient’s social history of recreational drug use should not be dismissed when considering potential etiologies.
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