We read with interest the short report by Leker and Biran,1 describing unidirectional dyslexia in a polyglot, and would like to offer alternative hypotheses for the symptomatology.

The case describes alexia while reading Hebrew, but not when reading English. This is a recognised neuro-ophthalmic phenomenon, which we have encountered in our practice in patients reading the Urdu language, another script written right to left.

The extent of reading difficulties in patients with hemianopia is well described.2 Patients with a right hemianopia cannot see letters following those already deciphered. Patients with a left hemianopia can read without difficulty, until they have to refixate the beginning of the next line which is in the hemianopic field, and their place in the text is then lost. It would be interesting to know if this was the case with this patient while reading English. Turning the page through 90° allows reading in the intact hemifield, and is standard advice to all patients with hemianopia.2 Also by turning a page through 180° the Hebrew text would have been readable and comprehensible, …

Dr R R Leker leker{at}cc.huji.ac.il