A 44-year-old man presented with a 4-month history of gradual vision loss in both eyes. He had a medical history of hypertension, anxiety, and posttraumatic stress disorder, for which he took amlodipine, lorazepam, citalopram, and quetiapine. He smoked 1.5 packs of cigarettes per day for the past 30 years and had a history of substantial alcohol use, drinking 2 to 3 L of wine per day. Because of excessive alcohol intake, he only ate 1 meal per day. His family history was unremarkable for optic nerve conditions or unexplained blindness.