Problem: Sarah, a 72-year-old female retired CEO reports that approximately a week ago she started experiencing decreased vision in her left eye associated with a "black spot" close to the center of her vision. The spot is present with both near and far vision and does not move away. She describes her vision as slightly blurry since then. She has also noted distortion of straight lines. Her daughter who lives with her adds that she has noticed her mother is having trouble distinguishing colors, which is something new. Sarah denies any recent trauma, eye pain, redness or discharge. Peripheral vision is normal. She has not had an eye exam in 5 years.