Some patients transitioning their gender from female to male require the use of testosterone as part of the reassignment procedure. There is an increasing number of case reports of these patients presenting with bilateral papilloedema secondary to testosterone use causing dysregulation of hormones.

The aim of this presentation is to show two cases of female to male transgender patients, aged 18 and 19 years, presenting to an outpatient ophthalmology unit with complications related to high dose testosterone. Both presented with bilateral papilloedema. The underlying cause for one patient was dural venous sinus thrombosis and for the other, idiopathic intracranial hypertension. Their signs and symptoms, investigations, treatment and patient outcomes and quality of life will be presented.

Given the increasing rates of gender transitions, it is important for eye health professionals to be aware of the adverse effects of medications for this patient cohort.