Robert Frost’s Inaugural Woes: A Differential Diagnosis for His Acute Vision Loss
Erin Finn1, Elizabeth Coon1
1Neurology, Mayo Clinic
Objective:
We explored American poet Robert Frost’s apparent acute vision loss during the 1961 presidential inauguration to determine why he appeared unable to recite his original poem, Dedication.
Background:
As the nation anticipated Frost's address, he stood mute. After an uncomfortable beat, he instead recited The Gift Outright from memory. 
Design/Methods:
Historical review of archival video from the 1961 presidential inauguration with analysis of Frost’s poetry and available records. 
Results:
In video documentation, Frost stands in direct sunlight and the glare of a reflecting pool. His mishap has been attributed to flash blindness, which is visual impairment from bright light oversaturating retinal pigment; it typically improves over seconds. Yet, no other speakers suffered a similar fate, so the differential should be expanded. Transient ischemic attack (TIA) in the distal branches of the left posterior cerebral artery causing alexia could be considered, supported by photos of him in later life with facial droop that are conceivably consistent with prior stroke and thus increase the likelihood of subsequent TIA. Migraine with visual aura can also cause transient blindness, although a poet as prolific as Frost likely would have referenced these in his work. Perhaps the most enticing explanation is bilateral loss of vision in response to exposure to bright light occurring with bilateral carotid occlusive disease. Further, Frost may have experienced this phenomenon prior, as evidenced by his poem Were I in Trouble, where he writes "A blinding headlight shifted glare." 
Conclusions:
Perhaps glare caused Frost’s temporary blindness on inauguration day, yet TIA with alexia, visual aura, or bilateral carotid occlusive disease should be considered. No matter the explanation for Frost's inaugural woes, it is in life as it is on rounds: always worth exploring the differential, whether it be for patient care, education, or satisfaction of a curious mind. 
10.1212/WNL.0000000000204483