Pleased to meet who?

Confusing grandchildren and snubbing a spouse are among the challenges faced by patients with impaired facial recognition


A woman meets a friendly man in a baseball cap at her graduation.

She nods through the conversation, and after he leaves, still struggling to place him, she turns to her sister and asks, “Who was that man?”

The sister replies: “Your husband.”

This was one of the scenarios described by Dr Andrew Logan during his presentation Have I seen your face before? Impairments of face recognition at 100% Optical on Sunday (5 February).

Other case studies Dr Logan referred to included a patient who worked at a cinema when she was growing up. Neighbours, relatives and friends would tell her parents that she was stuck-up because she did not recognise acquaintances when she sold them tickets.

Another patient could not recognise a man he had worked with for 20 years when he met him out of context at a restaurant.

Dr Logan detailed ocular diseases associated with impaired facial recognition, including age-related macular degeneration and glaucoma.

He also spoke about developmental and acquired prosopagnosia. Both conditions involve a profound inability to recognise faces, but the acquired form is caused by damage to a specific part of the brain, while developmental prosopagnosia is present at birth.

Dr Logan said that, regardless of the cause of the impairment, it could have a very negative impact on a patient’s quality of life.

“In some patients it may lead to things like depression or anxiety in social situations,” he added.

A patient had come to him recently who explained that she had problems with facial recognition as a result of a macular disease.

“She had her 80th birthday recently, all the family came to town, and she was okay with her daughters but when it came to her grandchildren she really couldn’t differentiate between them,” Dr Logan explained.

“You can understand that that is distressing,” he added.

Interviews with patients who struggled with facial recognition revealed a series of coping strategies, including identifying individuals by their voices, clothing or gait and posture.

Dr Logan highlighted that it was unlikely that a patient would come into an optometrist with facial recognition problems as their chief complaint.

“What might happen is that a patient comes in with symptoms of blurred vision, and when you start taking the history something comes up,” he said.

“For optometrists, the key thing is to exclude an ocular disease as an explanation for these symptoms. Clearly if a patient has age-related macular degeneration (AMD) that explains why they can’t recognise faces, but if the macular looks healthy, perhaps it’s worth not dismissing the patient’s symptom of impaired facial recognition,” Dr Logan emphasised.

Dr Logan is working on a project to quantify the impact that AMD has on visual sensitivity to faces.

He hopes to develop a test that can quickly and accurately determine how good an individual is at facial recognition.

Studies in facial recognition enjoyed a large amount of interest from a broad range of people and had practical applications, such as security at airports, Dr Logan noted.

“It’s an area of research that has real applications for daily life, but also it’s just inherently interesting,” he outlined.

Dr Logan concluded: “It’s a real puzzle – how can we look at so many faces and yet we can reliably and accurately sort one out from the other.”