Cortical blindness: A potential cure?

My aunt Jeannie died of brain cancer when she was just in her 30s. Though her death was tragic, her illness did allow me to witness firsthand a most curious vision impairment. A few months after her cancer was diagnosed, she suffered a stroke in her right visual cortex. Since the visual cortex in some ways serves as a mirror image of the area we're looking at, this meant that she had a very large blind spot covering most of the left side of her field of vision.

This cortical blindness is different from other sorts of blindness, because the viewer doesn't perceive that something is "missing" from the visual field: the brain simply doesn't process part of the visual information it receives from the eye. Jeannie wasn't even aware of what she was missing. If you placed a plate of food in front of her, she would eat the food on the right side of the plate, leaving the left side intact. You could rotate the plate 180 degrees so the food on the left was visible, and from her perspective it was as if new food appeared by magic.

But far from being amusing, this phenomenon upset Jeannie terribly: she felt as if she was being tricked, the butt of jokes. My mother, who was providing much of Jeannie's care, finally took to serving her food only on the right side of the plate.

Recent research has found, however, that people with cortical blindness do sometimes recognize stimuli presented in their blind spots: They can recognize, for example, whether a briefly flashed shape is a triangle or a square, at rates better than chance.

Now Scientific American has an article about a new experiment where people with cortical blindness were trained to recognize such shapes. After completing a home training session, they could recognize shapes in the lab 5 to 10 percent better than previously. Perhaps most interesting at all, if the laboratory tested a different part of the blind spot, where participants hadn't previously been trained, there was no vision improvement.

The researchers argue this is evidence that the visual cortex is adaptable, and that even long after the damage has occurred, the vision system may be able to self-adjust, perhaps using different portions of the visual cortex to perform the functions that had previously been lost.

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I'm teaching intro to cognitive psychology right now, and we're right in the middle of going over the visual system, attention, and all sorts of disorders associated with these kinds of processing.

We've learned about damage to the visual cortex which will make you blind (or blind in 1/2 of your field if it's unilateral). We're also in the middle of teaching about blindsight, when people who are blind in this way can still detect locations of lights that they cannot consciously perceive. We've also been talking about neglect, where you fail to notice what's going on in half of your visual field (almost always the left half). But neglect is an attentional disorder, not vision per se.

Given the anecdote about your aunt Jeannie, I'm actually wondering whether her disorder was neglect (and was damage to a parietal-attentional area) rather than visual (to the occipital cortex.) Someone with occipital damage would be more likely to move the plate into their working field so they could see the whole thing. With an attentional defecit, you'd always ignore the left side of any object, so moving the plate wouldn't help. And you wouldn't think to move the plate, because you're essentially ignoring what's going on in the left side of your visual field.

The other possibility is probably the most likely one, which is that rarely are these cases so cut-and-dry; her disorder could have been caused by a lesion that covered several areas of different kinds of processing.

Either way, thank you for sharing your story and the article. I look forward to telling my students about it.

Katherine,

Her lesion did indeed cover several areas -- she had difficulty moving the entire left side of her body. You're right; things are rarely as simple as science articles (or blog posts) make them seem.

Dave, in your description, it sounds as if your aunt had some hemiplegia, which often acompanies neglect. Katherine's comments were right on.

This plasticity of primary visual cortex is really cool, and not surprising. With a lot of training (and expensive perimetry equipment!) one could nearly train the brain out of cortical blindness -- I bet Charlie Gilbert would say so, anyway.

hi my name is shraneil and i am dealing with a kid with cortical bliness and its stressful not compehending with her

By shraneil coates (not verified) on 19 Nov 2007 #permalink