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This article presents a case of ethambutol toxic optic neuropathy determined during the routine optometric examination of a 66-year-old man. Ethambutol is an established drug for the treatment of tuberculosis, but has significant side effects, notably optic neuropathy. The prognosis for vision restoration is unpredictable, with the possibility of permanent vision loss. Treatment cessation is the only option to limit ocular damage; therefore, the early recognition of ethambutol optic neuropathy by optometrists is essential.