Acquired unilateral scotoma.

A 54-year-old white man presented with a "blind spot" temporally in his left eye. Best-corrected visual acuity in the affected eye was 20/20, and Humphrey visual field revealed an enlarged blind spot. Funduscopic examination revealed subtle peripapillary pigmentary changes corresponding to a well-demarcated peripapillary region of hyperautofluorescence and hypoautofluorescence on fundus autofluorescence. Outer retinal degenerative changes were detected on spectral-domain optical coherence tomography. A diagnosis of acute zonal occult outer retinopathy was made based on clinical history and imaging studies.