Neoplastic processes such as leukemia and lymphoma, ischemic processes including anterior ischemic optic neuropathy, and auto immune disorders including rheumatologic diseases (due to the heliotrope like rash and mother’s autoimmune history), neuromyelitis optica (NMO), and myelin oligodendrocyte glycoprotein (MOG) were considered. The gene discussed is MOG; the disease is anterior ischemic optic neuropathy.