Visual anosognosia on a patient due to bilateral ischemic occipital lobe strokes

A case report of a 60 year old female brought by her family to medical consultation because they noticed decreased visual function 2 days prior to medical evaluation. The patient denies having altered visual function. Her visual acuity was of hand motion on both eyes with no ocular findings to justify this vision.The patient was told she needed a Goldmann perimetry test and brain magnetic resonance imaging and to be evaluated in 24 hours, nevertheless, the patient returns one week later with a visual capacity of 20/250 in both eyes. By that time, the Goldmann perimetry shows complete left homonymous hemianopsia and peripheral reduction of temporal 30° on the right eye and nasal 10° on the left eye with partial preservation of fixation point. Magnetic resonance imaging shows right occipito-temporal ischemic lesion with bilateral small vessel occipital ischemia. Treatment is indicated by neuro-ophthalmology service and the patients were diagnosed with visual anosognosia associated to occipital ischemia, with gradual improvement of visual function by reperfusion of central nervous system.