Terminal Glaucoma Mimicking Posterior Cerebral Artery Infarction: A Case Report

Visual disturbances such as homonymous hemianopia and visual hallucinations often suggest central nervous system pathology, particularly occipital lobe infarction. However, ocular conditions may present similarly and lead to misdiagnosis. We report the case of a 73-year-old man presenting with right-sided visual field deficits and visual hallucinations, initially suggestive of posterior cerebral artery stroke. Neuroimaging and electroencephalograms were unremarkable. Further ophthalmologic evaluation revealed advanced normal-tension glaucoma (NTG) with bilateral field constriction and significant optic nerve cupping, consistent with terminal-stage NTG. The visual hallucinations were attributed to Charles Bonnet syndrome. This case underscores the importance of including ocular etiologies in the differential diagnosis of stroke mimics, particularly in elderly patients with visual complaints.