The most common problem first noticed by individuals with posterior cortical atrophy (PCA) is with vision. Quite understandably, this leads many people to consult their optician, but in fact the visual problems experienced are not related to the eye. Rather, the problems stem from the difficulty the affected brain has with interpreting the information sent to it by the healthy eyes. The precise nature of the visual problems experienced may vary widely but often include difficulty with some or all of the following:
- recognising objects in pictures (e.g. household items in a catalogue, especially if the pictures were taken from obscure angles or the picture is incomplete)
- recognising faces (e.g. TV characters, friends, relatives)
- appreciating the spatial location of objects around them (for example missing when reaching out to pick something up, finding it hard to press the correct numbers on a telephone, not seeing something you are looking for when it is right in front of you)
- judging distances (e.g. when driving, descending stairs).
- judging the speed of moving traffic
- perceiving movement among things which are stationary
- following the text when trying to read a book or newspaper, causing one to miss some lines of text or to read others twice
- reading particular words, finding that letters appear to move around or become superimposed over one another
- reading certain types of text (e.g. large print such as newspaper headlines, handwritten notes)
- experiencing objects as having an unusual colour
- experiencing increased sensitivity to bright light or shiny surfaces
- seeing clearly, experiencing double vision
- seeing clearly, feeling that one eyes are jerking around or not completely under one’s
However, vision is not the primary or only area of difficulty for everyone with posterior cortical atrophy. Skills such as literacy, numeracy, and the ability to make skilled movements may also be affected. Such difficulties may be experienced in the following ways:
- problems recalling the exact spelling of words
- difficulties with handwriting
- difficulties with remembering the shape or name of particular letters or numbers
- slowness and difficulty with mental arithmetic
- problems dealing with money and small change
- awkwardness making gestures (e.g. waving, thumbs up)
- difficulties with using particular tools, kitchenware or implements (e.g. cutlery, scissors, glasses)
- problems with dressing and clothing (partly related to difficulties with visual perception).
PCA can affect people in different ways initially. In some instances, the disease affects both sides of the brain equally, leading to a combination of many of the symptoms described above. For other people, the disease affects one particular brain area earlier or more significantly; as a result, problems with spelling and writing for example might be the first sign of the condition with vision relatively unaffected, whereas as for others, difficulties in seeing where objects are might be the initial symptom.