Optic neuropathy is a rare manifestation of systemic lupus erythematosus (SLE). In a previous series most patients with optic neuropathy in association with SLE had a final visual acuity of 20/200 or less despite corticosteroid therapy.

Three patients (five affected eyes) with severe retrobulbar optic neuropathy in association with SLE were treated promptly with intravenous cyclophosphamide and corticosteroids.

All patients recovered excellent visual acuity.

Although optic neuropathy in association with SLE might have several different aetiologies, intravenous cyclophosphamide should be strongly considered as a therapeutic alternative.