Anton’s syndrome consists of cortical blindness without the patient acknowledging or recognizing that they cannot see. The patient confabulates, answering questions about what they cannot see with confidence and insisting they can see.
This often leads to delay in recognizing the condition since the patient does not acknowledge seeing difficulties and visual problems are often attributed to problems with the eyes. Because blindness is cortical and subcortical pupillary reflex pathways are usually intact, pupils are usually reactive to light.
While Anton’s syndrome is rare, it is most commonly caused by ischemic infarction of bilateral occipital cortex. This can occur either by sequential infarcts of each posterior cerebral artery or through simultaneous infarction of both PCA vessels with a clot at the top of the basilar artery (with or without injury to other parts of the posterior circulation territory).
Anton’s should be distinguished from Charles Bonnet Syndrome, which is due to peripheral blindness, and Balint’s Syndrome which is associated with bilateral parietal cortex injuries.