The authors present a single case of posterior globe flattening without papilloedema in idiopathic intracranial hypertension. The case was a 64-year-old woman with a one-year history of transient visual loss in her left eye only. Visual acuity was 20/20 in both eyes and there was no relative afferent pupillary defect. She was found to have left optic disc oedema with a large peripapillary subretinal haemorrhage and diagnosed with unilateral papilloedema related to intracranial hypertension. Magnetic resonance imaging was performed on both orbits and showed flattening of the globe in the right eye, which did not have any disc oedema. The authors conclude that this flattening without papilloedema could suggest that the barrier to transmission of cerebrospinal fluid pressure to the optic nerve head is at the level of the lamina cribrosa and may be due to connective tissue changes in this area.