Is the vision really impaired? A case report of word blindness

Abstract

Word blindness or pure alexia refers to a condition that occurs due to lesions of the dominant occipitotemporal lobe, which is also known as the visual word form area (VWFA). This happens most commonly due to infarction in the territory of the posterior cerebral artery. A 66-year-old right-handed female patient presented to us with alexia without agraphia accompanied by right homonymous hemianopia. On evaluation, she showed marked impairment in the ability to read with grossly normal vision. Magnetic resonance imaging (MRI) brain revealed an acute infarct of the left occipital lobe with occlusion of the posterior cerebral artery (PCA). Infarction of the occipital lobe on the dominant side (left) in a right-handed individual can disrupt the VWFA and clinically it is manifested as a disconnection syndrome with an inability to read with preserved writing skills (alexia without agraphia) and gross normal vision.