A 56-year-old man with a unilateral central scotoma

A healthy 56-year-old man presented at the Bascom Palmer Eye Institute in Miami, Florida, with 3 days of small floaters and a central “purple spot” in his right eye. On review of social history, he acknowledged a sexual history that included sex with other men, most recently 4 months prior to presentation. A complete review of systems was otherwise negative, and he denied trauma or prior ophthalmic surgery.