Leber hereditary optic neuropathy (LHON) is an inherited mitochondrial disorder that typically presents in young men with painless, subacute, bilateral (simultaneous or sequential) central vision loss.1,2 Most cases have nonsimultaneous involvement of the contralateral eye in an interval less than 1 year.2,3 However, there are reports of loss of vision in the fellow eye over 1 year later. To date, the longest interval between affected eyes is 18 years.4 We present a patient with an interval of 41 years.