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A Being Patient report describes posterior cortical atrophy (PCA), a dementia syndrome that can first affect how the brain processes visual and spatial information rather than memory. The report follows Andrew Reid’s delayed diagnosis and outlines how PCA is evaluated, what treatments may be considered and why care can be difficult to access. There is no cure, and evidence for PCA-specific treatment remains limited.
A report by Being Patient examines posterior cortical atrophy (PCA), a dementia syndrome that can first impair the brain’s processing of visual and spatial information, and describes how one man’s symptoms went undiagnosed for about a year. The case highlights why people with PCA may consult eye-care providers before receiving a neurological diagnosis, even when the difficulty is in the brain rather than the eyes.
The report follows Andrew Reid, who began struggling to see his keyboard and write routine emails at work. He also had difficulty while driving. After a close call at an intersection, he went to an emergency department and was diagnosed with epilepsy, according to the account. His symptoms continued despite a year of treatment. At age 56, he and his wife, Karina, received a PCA diagnosis at a brain clinic.
PCA affects the brain regions involved in visual and spatial processing. Reported symptoms include trouble reading, judging distances, navigating, recognizing faces or objects, and sensitivity to bright light. People may also misplace items or struggle with tasks such as dressing. The report says these difficulties are not necessarily caused by an eye disorder. In Andrew’s case, his wife described eating as harder because he could lose the image of a fork while using it.
The report cites an estimate that Alzheimer’s disease underlies about 80 percent of PCA cases. Other reported causes include dementia with Lewy bodies, prion disease and other neurodegenerative conditions. As PCA progresses, it can also affect memory, language, speech and executive function. The article notes there is no cure; treatment may target symptoms or the underlying disease, but evidence specific to PCA is limited.
When Vision Problems Signal Brain Disease
PCA matters to patients and families because early symptoms can resemble ordinary vision problems while interfering with work, driving and daily activities. If the underlying difficulty is in the brain’s visual-processing systems, repeated eye checks alone may not explain what is happening. The report’s account shows how a delay or an incorrect initial diagnosis can leave a person without an explanation for worsening difficulties.
Recognition can also shape the support people receive. University College London researcher Keir Yong told Being Patient that services designed around memory loss may not fit people with PCA, whose most pressing needs can involve mobility, dressing and eating. A person may still have memory and insight while needing practical help with spatial tasks. That mismatch can affect assessment, care planning and access to services.
The report also cautions against assuming that treatments used for Alzheimer’s work equally well for PCA. Some medications may be considered depending on the cause, but the article describes limited evidence in PCA specifically. The condition’s effects, causes and treatment eligibility need to be assessed individually by clinicians.
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How PCA Can Be Missed
The report says the average age of symptom onset is about 59, and that diagnosis can take years because the symptoms differ from more familiar memory-led presentations of dementia. Andrew visited an optometrist three times without an eye problem being identified, according to the article. Yong told Being Patient that a cataract or another eye finding can sometimes be assumed to explain visual symptoms, potentially delaying investigation of the brain.
Guidance described in the report includes a detailed eye examination to rule out eye disease, along with blood tests to check for other conditions that can affect the brain. Cognitive testing and brain imaging may help identify problems in regions involved in visuospatial processing. Blood or cerebrospinal fluid tests and amyloid PET imaging may help determine whether Alzheimer’s is the underlying cause.
Yong is working with the UK Biobank on an optometrist screening test for PCA, the report says. It is being validated in eye and neurology clinics; the source does not report results or say when it might become available. A screening tool would not itself establish a diagnosis, but could help identify people who need further assessment.
““PCA sadly can be disabling in different ways.””
— Keir Yong, speaking to Being Patient
Treatment Evidence Remains Limited
The source report does not provide a publication date, detailed study results or a full clinical guideline, and several points remain unsettled. The effectiveness of Alzheimer’s drugs for people with PCA is not well established, according to the report. It says cholinesterase inhibitors may be prescribed for symptoms and that Alzheimer’s drugs such as Leqembi or Kisunla may be considered for eligible patients, but it does not establish how much people with PCA benefit.
The report also refers to a 2026 study finding that many people with atypical Alzheimer’s, including PCA, may not qualify for some drugs. It identifies visually weighted cognitive tests as a common reason, but does not give the study’s methods, sample size or exact eligibility criteria. The proposed optometrist screening test is still being validated, so its accuracy and eventual use are not yet clear.
PCA can have different underlying causes and progress differently. The source does not specify which services or accommodations are available in every location, or what level of support Andrew currently receives. Diagnosis and treatment choices require individual clinical assessment; the report is not a substitute for medical advice.
Screening and Care Need Validation
The next development described in the report is validation of the proposed optometrist screening test across eye and neurology clinics. The source does not provide a timeline or say when results will be released. Those findings will be needed to judge whether the test can help identify people who might otherwise face a prolonged path to diagnosis.
For people being assessed now, the report describes a process that may involve eye examinations, cognitive assessment, brain imaging and tests for the cause of symptoms. Researchers are also working on treatments, but the article reports no cure and limited PCA-specific treatment evidence. Further research would need to clarify how existing drugs perform in this group and how assessment and support can better address visual and spatial difficulties.
Key Questions
What is posterior cortical atrophy?
Posterior cortical atrophy is a syndrome in which damage to brain regions involved in visual and spatial processing makes tasks such as reading, navigating or judging distances difficult. The report says Alzheimer’s is the underlying cause in about 80 percent of cases, while other neurological diseases can also cause it.
Does PCA mean the eyes themselves are damaged?
Not necessarily. The visual problems described in PCA can result from difficulty in the brain’s processing of visual information, rather than a problem with the eyes. Eye examinations can help rule out separate eye conditions.
How is PCA assessed?
The report describes a detailed eye examination, blood tests to check for other possible causes, cognitive testing and brain imaging. Additional tests, including blood or cerebrospinal fluid tests and amyloid PET imaging, may help identify whether Alzheimer’s disease is responsible.
Is there a cure or established treatment for PCA?
The report says there is no cure. Clinicians may consider medicines based on the symptoms and underlying cause, but evidence about how well treatments work specifically for PCA is limited. A qualified clinician can advise on individual assessment and care.
Source: beingpatient.com
