A 23 year old man presented with a 10 day history of general malaise and a 1 week history of floaters in both eyes, predominantly in the right. He denied a febrile illness and exposure to animals. General medical history was unremarkable. He was not taking any medications.

On examination his visual acuity was 6/4-1 in the right eye and 6/4 in the left eye. Anterior chambers were quiet in both eyes. Dilated retinal examination showed 2+ vitreous cellular activity in the right eye and 1+ in the left eye, as well as evidence of bilateral neuroretinitis. The right optic disc was swollen with large dilated tortuous vessels associated with marked gliosis. The lesion was surrounded by lipid exudate and an inferior preretinal …