We report a case of a 31 year-old man who presented a bilateral ischem
ic optic neuropathy associated with headaches and severe systemic hype
rtension. This episode appeared after administration of ergotamine tar
trate and macrolides. This medication probably led to a vasospasm whic
h occurs in patients with hypertension. The cardiovascular and serum l
ipid evaluations were normal. A migraine optic neuropathy can be evoke
d.