A 23-year-old pregnant woman presented with a rapidly progressive unilateral optic neuropathy. The evaluation was complicated by her being pregnant and the issues surrounding the evaluation and management of the pregnant patient with a neuro-ophthalmic finding is discussed. Eventually an orbital apex lesion was found and proved to be an orbital schwannoma. Rapid growth of an orbital schwannoma should be included in the differential diagnosis of progressive visual loss in a pregnant patient.