Unawareness of blindness (Anton syndrome) is a form of anosognosia. In almost all previous case reports, the diagnosis of this syndrome has been made with neither objective quantitative neuropsychological data nor adequate descriptions of the underlying brain pathology.1 The confabulated visual experiences in Anton syndrome have also hardly been referred to, let alone accounted for. We report the case of a cortically blind woman (AST) with relatively well preserved cognitive skills who was anosognosic for blindness and reported perception of a frequently changing visual experience.

AST presented at the age of 67 years with a large (15 cm diameter) squamous cell carcinoma at the occiput. This was treated by radiotherapy, 50 Gy fractionated over 3 weeks, with good resolution of the tumour. Two years later it became apparent to others that she was progressively losing vision. She stopped reading and began bumping into objects around her home but denied visual impairment. She left slices of bread behind the toaster and teabags beside rather than in the teapot. She reported seeing non-existent animals, cars and people. She was further reported to have looked out of a window and described a new village that to her surprise had been built there. Two and a half years post-radiotherapy, she was assessed by us. Clinical examination revealed no light perception, …