A 41 year old white male presented to my office for a routine eye exam with symptoms of decreased near vision and mild, bifrontal headaches that he associated with the loss of his reading glasses. Refraction revealed normal visual acuities with a prescription for hyperopia and presbyopia. A dilated fundus exam indicated bilateral disc edema and diffuse tortuosity. A visual field utilizing a Humphrey Central 30-2 Threshold showed bilateral enlarged blindspots and an infero-nasal step in the left eye. Further diagnostic findings were then determined following referral to a neuro-ophthalmologist and internist: elevated intracranial pressure, normal CSF components including tumor markers, normal blood components, no focal CNS lesions utilizing MRI and a prominent suprasellar cistern with flattening of the pituitary. The diagnosis of pseudotumor cerebri and empty sella syndrome was determined with no evidence of a progressive underlying disease. The author will discuss the coexistence of these syndromes and their diagnosis, treatment, and patient profile. The case is unique in that both these syndromes are rarely seen in the adult male population and that the patient had few complaints. this case also illustrates the importance of co-management of patients between private practice optometry and the proper referral to advanced care.