| Summary: | Background: To date, the etiology of optic nerve sheath calcifications is unclear and visual loss secondary to optic nerve sheath calcifications has been reported infrequently. Case description: We report the case of a patient with an untreated parathyroid adenoma with longstanding elevated parathormone levels and hypercalcemia. This patient presented with optic atrophy and visual loss bilaterally (right worse than left) with associated exuberant calcification of the optic nerve sheaths and choroid plexus. Conclusions: Our patient demonstrates that metastatic optic nerve sheath calcification can occur in the setting of untreated hyperparathyroidism with longstanding hypercalcemia. Patients who present with optic nerve sheath calcification, with or without visual loss, should be studied for hypercalcemia and the possibility of an occult parathyroid adenoma should be considered as a possible cause. Keywords: Optic nerve sheath, Metastatic calcification, Optic atrophy, Hyperparathyroidism, Hypercalcemia, Visual deficit
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