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A highlight of my career was when a 33-year-old mother of two was referred to me with a diagnosis of hysterical blindness but the referring ophthalmologist questioned this diagnosis. The patient had bilateral occipital lobe infarction with bilateral homonymous visual field loss, but was also found to have ventral simultanagnosia and integrative agnosia.
Two months before I reviewed her she had been told she had hysterical blindness. The CT scan of the brain did not detect the occipital lobe infarction. This patient responded well to confirmation she had in fact lost much of her vision.
The diagnosis was confirmed for other physicians seeing this patient when the MRI scan became available 11 years later. The experience with this patient confirmed my long held belief that examination of vision must include examination of the brain as well as examination of the eyes themselves.
This belief led me from thoughts as a teenager to eventually studying Neuro-ophthalmology for four years abroad at the National Hospital for Nervous Diseases, Queen Square, London and at The Howe Laboratory, Harvard University in Boston, Massachusetts (1966 to 1969).
In 1985, with colleagues also fascinated by the neurology of vision we founded the Neuro-Ophthalmology Society of Australia which holds a clinical and scientific meeting annually.