A 26-year-old man with a blind spot in his left eye.

A 26-year-old white man presented with a 4-day history of a scotoma in the left eye only. He characterized the visual field defect as greenish and fixed in a superotemporal, paracentral location. The visual change was sudden in onset and was not associated with other ocular complaints or headache. Past ocular history was remarkable only for a diagnosis of herpes simplex keratitis in the involved eye. One episode had occurred 13 years before. It was treated with trifluridine and was not complicated by scarring or recurrence. Past medical history was unremarkable. Social history was negative for antecedent travel, illicit drugs, or trauma, but was positive for cat exposure. Review of systems was negative.