Progressive, sequential visual loss in the left and then right eye was reported in a 73-year-old male over three months. The presence of a family history of visual loss and the lack of other findings in association with bilateral cecocentral scotomata led to a diagnosis of new onset Leber's hereditary optic neuropathy, confirmed by the presence of a mutation at the 11778 position. This case illustrates that Leber's hereditary optic neuropathy may manifest late in life.