Cortical Blindness

The term cortical blindness is used synonymously with bilateral homonymous hemianopia. The definition includes

• Loss of all vision, including perception of light

• Loss of reflex blinking on being threatened

• Normal pupil response to light and convergence

• Full eye movements

It is common for patients with this disorder not to complain of the vision loss or to deny the blindness when confronted with the fact (Anton's syndrome). Remember that the condition commonly occurs from occlusion of the upper end of the basilar and the two posterior cerebral arteries. As the latter supply the inferior and medial surface of the temporal lobes as well as the primary visual cortex, an acute confusional amnesic syndrome may accompany the acute loss of vision. The latter may account for the denial of the blindness; that is, it is an agnosia.

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