Syndrome Affects Vision But Not Eyesight

Balint syndrome is a rare neurological disorder that impairs perception of objects

(RxWiki News) Imagine being able to see an object, but not be able to reach for it, identify it or understand it in context of its surroundings. For those living with Balint’s syndrome, this is an everyday reality that changes their entire way of life.

A recent study examined two cases of the rare syndrome caused by ischemic strokes. Balint’s syndrome is a debilitating neurological disorder that affects the patient’s ability to see and perceive without changing the patient’s eyesight.

"Tell a medical professional if you are feeling disorientated."

When a patient incurs an ischemic stroke, an artery to the brain is blocked sometimes resulting in damage to the brain. Patients with Balint’s syndrome have typically experienced damage to the parietal and occipital cortices due to this restriction of blood flow.

Balint’s syndrome is characterized by three main symptoms. These symptoms are oculomotor apraxia, optic ataxia and visual simultanagnosia.

People experiencing oculomotor apraxia may feel paralyzed when it comes to their gaze. They are unable to guide eye movements the way they intend to.

Optic ataxia can be considered as misreaching. An individual may see an object, but is unable to reach for it using sight alone.

Visual simultanagnosia is the inability of the brain to recognize what the eyes see.

In the study, Jason Cuomo, MD, and colleagues at the Loyola University Chicago Stritch School of Medicine, shared the stories of two patients with Balint’s syndrome.

A.S is a 68 year old woman from a suburb of Chicago and J.D. is a 66 year old male trucking business owner who immigrated to the United States from the former Soviet Union more than 30 years prior to being diagnosed with Balint’s syndrome.

A.S. originally thought she was having visual impairment and put herself to bed early. She was experiencing confusion and was unable to name or distinguish objects in her home.

The symptoms did not go away.

Her inability to do simple things such as perceive the kitchen sink greatly affected her daily life. She learned how to compensate with her other senses like touch or by color outlining objects, as she can perceive the color yellow.

A.S. can no longer read, but learned to adapt by listening to audiobooks and radio.

Balint syndrome in J.D. first showed while he was driving. His family thought his unusual behavior was due to fatigue.

J.D. then experienced left-sided weakness, facial drooping and the loss of memory and consciousness. He has worked to regain as much normal function as possible.

After beginning recovery, J.D.’s main challenges were his verbal abilities and simultanagnosia. He experienced frustration with not being able to find words and perceived only one object at a time.

He depended on his wife to translate for him. His loss of independence was very difficult and took an emotional toll.

For both patients, adaptation has become key.

Another important aspect is awareness of the disease. Most neurologists are aware of the syndrome, but the debilitating effects on everyday life are often difficult to grasp.

This syndrome demonstrates how one aspect of human function can deeply affect another. The dailyRx spoke with Chris Quinn, OD, an optometrist with Omni Eye Service.

“What is most interesting about this discussion is the importance of recognizing the complexity of vision and how interrelated functions of the brain can cause such significant visual disturbances,” said Dr. Quinn.

“Good visual acuity, demonstrated by the ability to read letters on an eye chart, is only the first step in visual processing and can lead to a false sense of security if a screening or examination demonstrates that acuity is normal,” added Dr. Quinn.

The study was published in the September in Neurology, the medical journal of the American Academy of Neurology.

The authors report no conflict of interest.

Review Date: 
October 8, 2012