Seeing but not identifying: pure alexia coincident with prosopagnosia in occipital arteriovenous malformation

Pure alexia and prosopagnosia are two separate and uncommon disorders of visual recognition in neuro-ophthalmology. We report an extremely rare case of pure alexia coincident with prosopagnosia secondary to occipital arteriovenous malformation. The manifestations of these two visual recognition disorders are also described. A 35-year-old, left-handed women had suffered from severe blurred vision when recognizing her family's faces and was unable to read or associate separate parts of a word into a whole word. Her visual field revealed slight right homonymous hemianopia. Computed tomography scans and magnetic resonance images were arranged and vertebral angiography confirmed the diagnosis of left occipital arteriovenous malformation. Gamma-knife stereoscopic radiotherapy was performed. Two months after the treatment, the ability to recognize faces and read improved and the visual field recovered. Ophthalmologists should keep in mind that usual complaints of blurred vision might correlate with unusual visual recognition disorders. Pure alexia and prosopagnosia have not been reported to occur together and the left-handed- dominance in our case leads to this scarce concurrence.