Impacts of impaired face perception on social interactions and quality of life in age-related macular degeneration

A qualitative study and new community resources

Jo Lane, Emilie M.F. Rohan, Faran Sabeti, Rohan W. Essex, Ted Maddess, Amy Dawel, Rachel A. Robbins, Nick Barnes, Xuming He, Elinor McKone

Research output: Contribution to journalArticle

2 Citations (Scopus)
8 Downloads (Pure)

Abstract

Aims

Previous studies and community information about everyday difficulties in age-related macular degeneration (AMD) have focussed on domains such as reading and driving. Here, we provide the first in-depth examination of how impaired face perception impacts social interactions and quality of life in AMD. We also develop a Faces and Social Life in AMD brochure and information sheet, plus accompanying conversation starter, aimed at AMD patients and those who interact with them (family, friends, nursing home staff).

Method

Semi-structured face-to-face interviews were conducted with 21 AMD patients covering the full range from mild vision loss to legally blind. Thematic analysis was used to explore the range of patient experiences.

Results

Patients reported faces appeared blurred and/or distorted. They described recurrent failures to recognise others' identity, facial expressions and emotional states, plus failures of alternative non-face strategies (e.g., hairstyle, voice). They reported failures to follow social nuances (e.g., to pick up that someone was joking), and feelings of missing out ('I can't join in'). Concern about offending others (e.g., by unintentionally ignoring them) was common, as were concerns of appearing fraudulent ('Other people don't understand'). Many reported social disengagement. Many reported specifically face-perception-related reductions in social life, confidence, and quality of life. All effects were observed even with only mild vision loss. Patients endorsed the value of our Faces and Social Life in AMD Information Sheet, developed from the interview results, and supported future technological assistance (digital image enhancement).

Conclusion

Poor face perception in AMD is an important domain contributing to impaired social interactions and quality of life. This domain should be directly assessed in quantitative quality of life measures, and in resources designed to improve community understanding. The identity-related social difficulties mirror those in prosopagnosia, of cortical rather than retinal origin, implying findings may generalise to all low-vision disorders

Original languageEnglish
Article numbere0209218
JournalPLoS One
Volume13
Issue number12
DOIs
Publication statusPublished - 1 Dec 2018

Fingerprint

Macular Degeneration
Interpersonal Relations
quality of life
Quality of Life
Starters
Nursing
Image enhancement
Mirrors
interviews
vision disorders
Prosopagnosia
Family Nursing
Interviews
Image Enhancement
nursing homes
Low Vision
social impact
Social Identification
Facial Expression
Nursing Staff

Cite this

Lane, Jo ; Rohan, Emilie M.F. ; Sabeti, Faran ; Essex, Rohan W. ; Maddess, Ted ; Dawel, Amy ; Robbins, Rachel A. ; Barnes, Nick ; He, Xuming ; McKone, Elinor. / Impacts of impaired face perception on social interactions and quality of life in age-related macular degeneration : A qualitative study and new community resources. In: PLoS One. 2018 ; Vol. 13, No. 12.
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title = "Impacts of impaired face perception on social interactions and quality of life in age-related macular degeneration: A qualitative study and new community resources",
abstract = "AimsPrevious studies and community information about everyday difficulties in age-related macular degeneration (AMD) have focussed on domains such as reading and driving. Here, we provide the first in-depth examination of how impaired face perception impacts social interactions and quality of life in AMD. We also develop a Faces and Social Life in AMD brochure and information sheet, plus accompanying conversation starter, aimed at AMD patients and those who interact with them (family, friends, nursing home staff).MethodSemi-structured face-to-face interviews were conducted with 21 AMD patients covering the full range from mild vision loss to legally blind. Thematic analysis was used to explore the range of patient experiences.ResultsPatients reported faces appeared blurred and/or distorted. They described recurrent failures to recognise others' identity, facial expressions and emotional states, plus failures of alternative non-face strategies (e.g., hairstyle, voice). They reported failures to follow social nuances (e.g., to pick up that someone was joking), and feelings of missing out ('I can't join in'). Concern about offending others (e.g., by unintentionally ignoring them) was common, as were concerns of appearing fraudulent ('Other people don't understand'). Many reported social disengagement. Many reported specifically face-perception-related reductions in social life, confidence, and quality of life. All effects were observed even with only mild vision loss. Patients endorsed the value of our Faces and Social Life in AMD Information Sheet, developed from the interview results, and supported future technological assistance (digital image enhancement).ConclusionPoor face perception in AMD is an important domain contributing to impaired social interactions and quality of life. This domain should be directly assessed in quantitative quality of life measures, and in resources designed to improve community understanding. The identity-related social difficulties mirror those in prosopagnosia, of cortical rather than retinal origin, implying findings may generalise to all low-vision disorders",
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Impacts of impaired face perception on social interactions and quality of life in age-related macular degeneration : A qualitative study and new community resources. / Lane, Jo; Rohan, Emilie M.F.; Sabeti, Faran; Essex, Rohan W.; Maddess, Ted; Dawel, Amy; Robbins, Rachel A.; Barnes, Nick; He, Xuming; McKone, Elinor.

In: PLoS One, Vol. 13, No. 12, e0209218, 01.12.2018.

Research output: Contribution to journalArticle

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AU - Sabeti, Faran

AU - Essex, Rohan W.

AU - Maddess, Ted

AU - Dawel, Amy

AU - Robbins, Rachel A.

AU - Barnes, Nick

AU - He, Xuming

AU - McKone, Elinor

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N2 - AimsPrevious studies and community information about everyday difficulties in age-related macular degeneration (AMD) have focussed on domains such as reading and driving. Here, we provide the first in-depth examination of how impaired face perception impacts social interactions and quality of life in AMD. We also develop a Faces and Social Life in AMD brochure and information sheet, plus accompanying conversation starter, aimed at AMD patients and those who interact with them (family, friends, nursing home staff).MethodSemi-structured face-to-face interviews were conducted with 21 AMD patients covering the full range from mild vision loss to legally blind. Thematic analysis was used to explore the range of patient experiences.ResultsPatients reported faces appeared blurred and/or distorted. They described recurrent failures to recognise others' identity, facial expressions and emotional states, plus failures of alternative non-face strategies (e.g., hairstyle, voice). They reported failures to follow social nuances (e.g., to pick up that someone was joking), and feelings of missing out ('I can't join in'). Concern about offending others (e.g., by unintentionally ignoring them) was common, as were concerns of appearing fraudulent ('Other people don't understand'). Many reported social disengagement. Many reported specifically face-perception-related reductions in social life, confidence, and quality of life. All effects were observed even with only mild vision loss. Patients endorsed the value of our Faces and Social Life in AMD Information Sheet, developed from the interview results, and supported future technological assistance (digital image enhancement).ConclusionPoor face perception in AMD is an important domain contributing to impaired social interactions and quality of life. This domain should be directly assessed in quantitative quality of life measures, and in resources designed to improve community understanding. The identity-related social difficulties mirror those in prosopagnosia, of cortical rather than retinal origin, implying findings may generalise to all low-vision disorders

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