Presentation
The defect becomes apparent when patients are found describing people or surroundings that are not present, or walking into objects, though the patient will continue to deny that they cannot see even when presented with evidence otherwise. [eyewiki.aao.org]
Case presentation We present a case report of an 83-year-old white woman with cortical blindness as a result of bilateral occipital lobe infarcts. [ncbi.nlm.nih.gov]
The aim of this study is to present our experience in clinical presentation, diagnosis and complications of patients with OHVIRA syndrome in a 20-year period. [read.qxmd.com]
Mr B presented to the emergency department because of frequent falls and an inability to grasp anything in front of him. He could recognise his family by their voices but not by sight. [sbs.com.au]
Entire Body System
- Collapse
Case presentation An 83-year-old white woman with a background of mild dementia, hypothyroidism and a resected gastric carcinoma 20 years earlier was found collapsed on the floor of her house. [ncbi.nlm.nih.gov]
- Malingering
Patients who are malingering and in fact have no visual deficit can be identified by an ophthalmologist by using visual evoked potentials which demonstrates intact central visual function. [11] Treatment for Anton Syndrome will depend on the treatment [eyewiki.aao.org]
Cardiovascular
- Hypertension
It is most commonly reported after cortical blindness due to cerebrovascular accident but has been reported in literature in pregnancy induced hypertensive encephalopathy [6], trauma [4], as result of MS exacerbation [3], among other causes. [eyewiki.aao.org]
Good recovery of visual function has been noted in conditions causing Anton's syndrome such as hypertensive encephalopathy and cortical hypoperfusion [ 12, 13 ]. [ncbi.nlm.nih.gov]
Musculoskeletal
- Contusion
Anton's syndrome in a patient with posttraumatic optic neuropathy and bifrontal contusions. Arch Neurol. 1991;48:101–105 ↑ 5.0 5.1 5.2 Zukić S, Sinanović O, Zonić L, Hodžić R, Mujagić S, Smajlović E. [eyewiki.aao.org]
Anton's syndrome in a patient with posttraumatic optic neuropathy and bifrontal contusions. Arch Neurol. 1991; 48 :101–105. [ PubMed ] [ Google Scholar ] [ncbi.nlm.nih.gov]
Eyes
- Retinal Hemorrhage
hemorrhages due to hypertensive encephalopathy, optic nerve damage due to trauma, RAPD and/or INO due to MS for example. [eyewiki.aao.org]
Psychiatrical
- Auditory Hallucination
Patients with psychotic disorders are more likely to experience auditory hallucinations which are not associated with Anton Syndrome. [eyewiki.aao.org]
- Suggestibility
One suggests that the monitor of visual stimuli is defective and is incorrectly interpreting images. The other suggests the presence of false feedback from another visual system. [ncbi.nlm.nih.gov]
Neurologic
- Stroke
The most common cause and most irreversible cause of this condition is cerebrovascular accident, therefore prevention should be focused on typical stroke prevention. [eyewiki.aao.org]
Brain imaging revealed strokes that had damaged his visual cortex. Mr B had a rare condition called Anton’s syndrome, characterised by denial of blindness. [sbs.com.au]
On arrival to the stroke unit, the patient's Glasgow Coma Scale score (GCS) was 15 out of 15 and she had normal power in all four limbs and no sensory loss. Her most striking clinical feature on examination was severe impairment of visual acuity. [ncbi.nlm.nih.gov]
January 24, 2019: Endocrine # 50 Barjinder S Buttar, Alan T Kaell Vivid visual hallucinations are common in the geriatric population and can be due to a number of causes such as dementia, delirium, stroke, adverse effects of medication, or ocular disease [read.qxmd.com]
- Confabulation
Classically, patients with this syndrome dismiss the diagnosis and confabulate visions. [eyewiki.aao.org]
Anton's syndrome is the denial of loss of vision (visual anosognosia) associated with confabulation in the setting of obvious visual loss and cortical blindness. [ncbi.nlm.nih.gov]
- Encephalopathy
It is most commonly reported after cortical blindness due to cerebrovascular accident but has been reported in literature in pregnancy induced hypertensive encephalopathy [6], trauma [4], as result of MS exacerbation [3], among other causes. [eyewiki.aao.org]
Good recovery of visual function has been noted in conditions causing Anton's syndrome such as hypertensive encephalopathy and cortical hypoperfusion [ 12, 13 ]. [ncbi.nlm.nih.gov]
Workup
Other Pathologies
- White Matter Lesions
matter lesions leading to a disconnection syndrome. [5] Also, as the connection between the damaged visual cortex and operating speech language areas is severed, it is possible that without input, the speech regions of the brain are responsible for confabulating [eyewiki.aao.org]
Treatment
Surgery There is currently no surgical treatment option for Anton Syndrome. [eyewiki.aao.org]
Delay in diagnosis and treatment can produce serious complications in patient's life and fertility. [read.qxmd.com]
But, says one man living with the disease, there is a way to save sight: catch it early and allow genetic therapy research enough time to create better treatment options. [sbs.com.au]
Prognosis
[…] as result of bilateral occipital cortical infarction, the prognosis is poor and patients are unlikely to ever fully recover. [1] ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 Maddula M, Lutton S, Keegan B. [eyewiki.aao.org]
Cortical blindness: etiology, diagnosis, and prognosis. Ann Neurol. 1987; 21 :149–158. doi: 10.1002/ana.410210207. [ PubMed ] [ CrossRef ] [ Google Scholar ] Misra M, Rath S, Mohanty AB. [ncbi.nlm.nih.gov]
Etiology
Though the literature is extremely limited, this syndrome has also been reported in younger age groups when etiology is non-vascular. [eyewiki.aao.org]
Cortical blindness: etiology, diagnosis, and prognosis. Ann Neurol. 1987; 21 :149–158. doi: 10.1002/ana.410210207. [ PubMed ] [ CrossRef ] [ Google Scholar ] Misra M, Rath S, Mohanty AB. [ncbi.nlm.nih.gov]
Epidemiology
Epidemiology Anton Syndrome is most commonly secondary to cerebrovascular accident, so is primarily seen in elderly individuals with multiple vascular risk factors. [eyewiki.aao.org]
Pathophysiology
General Pathology/Pathophysiology The exact pathophysiology of Anton Syndrome is unknown. [eyewiki.aao.org]
Prevention
There is no specific primary prevention for Anton Syndrome. [eyewiki.aao.org]
Management in these circumstances should accordingly focus on secondary prevention and rehabilitation. [ncbi.nlm.nih.gov]
It is related to several conditions in which the physical therapy could take action-preventing co-morbidities. [read.qxmd.com]