Visual Agnosia and Prosopagnosia With or Without Achromatopsia? Case Report

Visual stimulus coming to the primary visual cortex are processed by adjacent areas and thought inter-hemispheric pathways to allow the visual perception of objects and forms as well as recognition of faces and colours. We present a patient with a bilateral asymmetrical occipital infarct whose visual acuity and visual fields should allow him to recognise objects but he only could do that using another sense like touch or earring - visual agnosia. When faced with a mirror he could not recognise himself- prosopagnosia. All the colours presented to him were said to brown- central achromatopsia. We describe the strategy used that allowed us to distinguish that this was not a real achromatopsia but rather the result of visual agnosia. Syndromes of pure visual miss perception are rare, always coming from bilateral cortical lesions and the general ophthalmologist should be aware of its existence not to be called a functional problem.