In this segment of the 2013 Neuro-Ophthalmology Subspecialty Day series on recognizing distinctive neuro-ophthalmic symptoms, signs, and tests, Bradley Katz presents to panelists Anthony Arnold, Lanning Kline, Mark Kupersmith, and Valerie Purvin the case of a 69-year-old man who was referred by his ophthalmologist for visual field loss and pallor of the optic nerves out of proportion to atrophy. The patient described long-standing poor vision, worsening slightly the last 20 years. He had missing spots of vision and difficulty distinguishing shades of colors. Parts of words were missing when he read. Past ophthalmic history was notable for moderate myopia.