A Chicago woman with 20/20 vision hopes to one day "see again" after a series of strokes left her unable to process the scenes around her, according to a new case study.
The 68-year-old woman, dubbed A.S. in the study, thought her vision was failing when she woke up from a nap and fumbled to find her bedroom door.
"We took her to an eye doctor, because we didn't know what it was at the time," her husband, Michael, told the study authors. "They ran tests on her eyes, and she passed them with flying colors!"
A brain scan later revealed A.S. had Bálint syndrome, a rare condition caused by damage to the brain areas that process and integrate visual information.
"Her primary vision is fine," said study author Dr. Murray Flaster, medical director of neurology at Loyola Outpatient Clinic in Maywood, Ill., explaining how the eyes and the nerves that receive visual information remain intact. "It's the second step of relating one thing to another she has trouble with."
A busy neurologist sees a handful of Bálint syndrome cases in a lifetime, according to Flaster. The unusual condition, triggered by strokes or tumors in the back of the brain, restricts the amount of visual information a person can process.
"Basically a person can see things, but they can't gauge their position in space," said Flaster, describing how A.S. was unable to tell where her bedroom wall ended and the doorway began. "It's like a funny sort of tunnel vision."
People with Bálint syndrome are also unable to rely on visual cues to guide their own movements, making simple tasks like tooth-brushing much more complicated.
"Because [A.S.] cannot trust her eyes to direct the toothpaste to her toothbrush, she must put the toothpaste directly in her mouth, and by trial and error move the toothbrush to meet it," Flaster and colleagues wrote in their study, published today in the journal Neurology. And "she has learned that she must touch the sink at all times in order to remain oriented -- otherwise her eyes are as good as closed."
The study also describes a 62-year-old man, dubbed J.D., who started showing the strange signs of Bálint syndrome while serving Thanksgiving dinner.
"He was holding the spoon upside down. We all laughed," J.D.'s daughter told the study authors. "We just thought he was tired."
Once a hardworking trucker, J.D. is struggling to adapt to life with Bálint syndrome and suffers from depression, according to the study.
"I think that's the worst part for him because he's a man with a lot of pride who worked all his life, and now he can't do anything," his daughter said.
"Obviously it's distressing for patients," said Flaster, adding that finding ways to recover function is key for living with Bálint syndrome.
A.S. had her son put bright yellow tape around doorways and cupboards to help highlight the edges. And because she can no longer read -- a skill that requires seeing letters in the context of words, and words in the context of sentences -- she traded her morning paper for the radio and listens to books on tape. She hopes her story will prompt research into Bálint syndrome treatments.
"I'm talking to you for one reason," she told the researchers. "Because I think if more people know about it, they won't go through what I've gone through."