Papillophlebitis is an uncommon disease in clinical practice. We would like to present a case of a 29-year-old patient with atypical orbital pain and fl ashings, presenting relative aff erent pupillary defect and already typical of the disease entity: ophthalmoscopic picture of the fundus and big blind spot in perimetry. We present a complex and interdisciplinary diagnostic process that excludes general diseases such as hypertension, diabetes, coagulation disorders and neurological causes. We leave the only identifiable abnormality and potential source in the infl ammatory process of periodontal infl ammation and sinus jaw changes. We also describe the process of remitting the changes and fi nally a favorable end result of the primarily a very disturbing clinical picture that this disease may present.