The presentation of bilateral incongruous paracentral scotomata in an otherwise well 21 year old woman was found to correspond to dark, red-brown, wedge-shaped lesions surrounding the macula. Like previously described cases of acute macular neuroretinopathy, these lesions seemed to be located in the superficial retina and appeared to be associated with oral contraceptive use and a recent history of viral illness. At follow-up 8 months after presentation, the scotomata were persistent and unchanged. No treatment is known.