A 45 year old male presents to the eye doctor with symptoms of decreased vision and floaters in his left eye. He says that the symptoms have been gradually worsening for the last several weeks, and has never had such symptoms before. There are no symptoms of flashes or visual field loss, and he has no complaints with the right eye.
The patient reports being otherwise healthy and is on no medications. However, he does tell you he had a painless ulcer on the shaft of his penis about 2 months ago which lasted for several weeks before resolving. His sexual history is significant for multiple male partners. He has never been screened for sexually transmitted infections.
On exam, visual acuity is 6/7.5 and 6/15 in the right and left eyes, respectively. Anterior segment exam is normal in both eyes. In the left eye, multiple yellow-gray inflammatory lesions are seen on the posterior pole and are associated with mild vitritis.