By Jason Burton, MD
VCU Health System
In a previous issue, I have written about Charles Bonnet Syndrome, a condition in which individuals with visual loss experience vivid visual hallucinations that they recognize as unreal.
As we continue exploring fascinating clinical syndromes, consider a different kind of blindness, one where the mind not only misinterprets the deficit, but denies it altogether. A blindness in which the person insists they can still see perfectly.
This is the reality of Anton Syndrome (also known as Anton-Babinski Syndrome), a rare neurological condition in which a person who is cortically blind, usually due to occipital lobe damage, firmly believes their vision is intact. Individuals with Anton Syndrome deny the obvious blindness, often confabulating when asked what they see, offering detailed, yet entirely fabricated responses.
Anton Syndrome has two key features:
- Anosognosia – a lack of awareness or denial of the deficit
- Confabulation – the spontaneous filling in of missing information with invented content
These patients are not intentionally deceptive; they truly do not perceive their blindness. Many cases are only uncovered when the patient walks into walls or trips over obstacles, insisting they saw and tried to avoid. Often, they explain their difficulties navigating with excuses about poor lighting or other situational confabulations.
The syndrome most commonly arises after bilateral occipital lobe damage, typically from a stroke. But the real mystery lies not in the blindness itself, but in the brain’s response to it. Why does the mind construct a fiction in place of a sensory deficit?
One theory suggests that while the visual cortex is damaged, so is the connection between visual and language areas, such as the pathways from the occipital lobe to Broca’s or Wernicke’s areas. Unable to process visual input and deprived of reliable connections to the language centers, the brain may default to automatic narrative generation. This draws fascinating parallels to callosal disconnection syndromes, where the speech centers cannot access visual information from the nondominant hemisphere, leading to similar gaps that are filled with confabulation.
As I often tell medical students when discussing confabulation, our brains are inference machines, constantly trying to tell a coherent story. When faced with ambiguity or contradiction, the brain will do whatever it can to square the circle, and often we are unaware of the process.
Anton Syndrome challenges our assumptions about self-awareness and the narrative nature of the mind. It forces us to consider the possibility that we may be blind to our own deficits, perhaps not as dramatically as in Anton Syndrome, but no less meaningfully. Our brains, ever the inference storytelling machine, may be filling in more blanks than we care to admit.
Sources and further reading
- Das JM, Naqvi IA. Anton Syndrome. [Updated 2023 Apr 3]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan. https://www.ncbi.nlm.nih.gov/books/NBK538155/
- Chaudhry FB, Raza S, Ahmad U. Anton’s syndrome: a rare and unusual form of blindness. BMJ Case Rep. 2019 Dec 3;12(12):e228103. doi: 10.1136/bcr-2018-228103. PMID: 31801772; PMCID: PMC7001702.
