A 39 year old white male who had a history of cocaine, heroin, and ethanol abuse presented with decreased central vision in the right eye from central serous chorioretinopathy. Over two months later, he complained of a sudden onset of pain over the left eye with nasal vision loss. Visual field testing revealed a right homonymous superior quadranopsia. Neurological consultation demonstrated a left occipital lobe infarction with an unrelated ethmoidal and maxillary sinusitis. The presence of multiple disorders occurring simultaneously confounded the initial clinical presentation which necessitated further laboratory and radiological testing.