An 80-year-old woman presented with a classic story and findings of an anterior ischemic optic neuropathy in her left eye. Her right eye had slow and progressive decreased vision, ostensibly secondary to a cataract. However, the right eye showed slight temporal pallor of the optic disc and a superior temporal field defect was found. Her radiologic exam showed a tuberculum sella meningioma extending into the right optic canal compressing the right optic nerve. Two diseases, ischemic optic neuropathy and meningioma, in one patient may be termed a pseudo-pseudo-Foster Kennedy syndrome.