What Is Posterior Cortical Atrophy? One Couple’s Road To Diagnosis

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Scott Cunningham was diagnosed with posterior cortical atrophy (PCA) in December 2020 after years of difficulties with visual and spatial tasks, despite treatment for cataracts. His wife, Anne, helped connect the changes, and an ophthalmologist recognized that his eyes appeared healthy. Their account, published by Being Patient, illustrates how PCA symptoms can be mistaken for an eye problem; the interview does not establish a general treatment or prognosis for people with PCA.

Retired psychiatrist Scott Cunningham was diagnosed with posterior cortical atrophy (PCA) in December 2020, after years of trouble with tasks involving vision and spatial processing that cataract treatment did not resolve. In an interview published by Being Patient, Scott and his wife, Anne, describe how everyday difficulties and an ophthalmologist’s observation that his eyeballs appeared normal helped lead to further investigation and a diagnosis.

Scott said his difficulties began subtly, about six or seven years before the interview, with tasks he had previously managed. He recalled cutting a board unevenly and being unable to assemble a log rack by following its instructions. Anne noticed some of the changes before he understood them as possible symptoms. Scott also described increasing difficulty entering detailed financial information on a computer and following board games that relied on recognizing shapes and their positions.

He first sought help for what seemed to be a vision problem. An ophthalmologist attributed some of the issue to cataracts, and Scott underwent cataract procedures in both eyes. He said his vision was somewhat better afterward but still did not feel right. At a later visit, he recalled, the ophthalmologist emphasized that his eyeballs appeared normal, prompting recognition that the difficulty might not originate in the eyes themselves. The interview says a brain scan later confirmed the PCA diagnosis.

Scott told Being Patient that he carries two copies of the ApoE4 gene and is participating in the third year of a five-year gene therapy clinical trial. He and Anne also discussed his neurologist’s advice against anti-amyloid treatment in light of his ApoE4 status, as well as practical changes that have helped him maintain independence. The report does not provide trial results or describe the specific changes in detail.

When Vision Problems Begin in the Brain

The Cunninghams’ account illustrates why PCA can be difficult to recognize: a person may have trouble making sense of visual information, judging spatial relationships or finding objects even when the eyes themselves are relatively healthy. That mismatch can lead people to seek eye care first and may delay recognition of a neurological cause, as Scott’s experience suggests.

The story also shows the role family observations can play. Anne noticed changes in familiar activities, while Scott initially interpreted individual setbacks as isolated problems. The interview is one couple’s account, not a measure of how often PCA is missed or how every patient experiences diagnosis. Still, it draws attention to the need to assess both eye health and how the brain processes what a person sees.

Scott’s Path From Eye Care to Diagnosis

PCA is described in the Being Patient report as a rare form of Alzheimer’s disease that tends to affect visual and spatial processing before memory becomes the most apparent concern. Possible difficulties include reading, locating objects, judging distances and interpreting what is seen. The interview does not suggest that any one of these problems on its own establishes a PCA diagnosis.

Scott said he had no known family history of Alzheimer’s disease and had worked as a psychiatrist for 40 years. His initial changes unfolded over time: trouble with hands-on projects, computer-based finances, an analog clock and family games. He first associated the problem with his vision, underwent cataract treatment, and continued to report difficulties. A brain scan ultimately confirmed the diagnosis in December 2020, according to the report.

Being Patient identifies the interview as part of its “Journey to Diagnosis” series and says the series was sponsored by Eisai. The outlet states that the sponsor had no role in choosing guests, shaping questions or reviewing the interview before publication. That disclosure provides relevant information about the report’s funding while leaving its account attributable to the couple and the outlet.

““I failed. Could you try this?””

— Scott Cunningham, describing his early difficulty with a household project

Questions Beyond One Diagnosis Story

The interview does not provide Scott’s scan findings, the full diagnostic work-up or a detailed clinical explanation of how doctors distinguished PCA from other causes of visual difficulty. It also does not establish how long diagnosis typically takes or how common delays are. The couple’s experience should not be treated as a diagnostic checklist for others.

Scott’s participation in a gene therapy trial is reported, but the article excerpt provides no information about the trial’s design, goals, safety findings or outcome. His neurologist’s advice regarding anti-amyloid treatment is specific to his reported circumstances; the interview does not give enough clinical detail to draw conclusions about treatment choices for other people. Medical decisions should be discussed with qualified clinicians familiar with an individual’s case.

Trial Participation and Ongoing Care

Scott’s reported next milestone is completion of the five-year gene therapy clinical trial; at the time covered in the interview, he was in its third year. The report does not state when the trial will conclude or whether results are expected to be published on a particular schedule. No new test result or treatment decision is announced in the interview.

For the Cunninghams, ongoing care also includes adapting everyday activities to help Scott remain independent. The couple raised concerns about vision services in PCA care, but the interview does not announce a change to clinical services or guidance. Readers experiencing persistent visual or spatial difficulties should seek professional assessment rather than infer a diagnosis from this account.

Key Questions

What is posterior cortical atrophy?

Posterior cortical atrophy is described in the report as a rare form of Alzheimer’s disease that often first affects visual and spatial processing. People may have difficulty interpreting what they see despite relatively normal eyesight.

What symptoms did Scott Cunningham describe?

Scott recalled trouble cutting a board straight, assembling a log rack, managing detailed computer-based finances and playing a visually demanding board game. These are details from his personal account, not a diagnostic checklist.

Why did cataract treatment not resolve his difficulties?

Scott said cataract procedures improved things somewhat but did not resolve his concern that his vision was still not right. His ophthalmologist later said his eyeballs appeared normal; a brain scan subsequently confirmed PCA, according to Being Patient.

Does Scott’s experience show which treatment is right for PCA?

No. The interview reports that Scott’s neurologist advised against anti-amyloid treatment in light of his ApoE4 status, but it does not provide enough medical detail to apply that decision to others. Treatment decisions require advice from a qualified clinician.

Source: rss