For the first time, scientists have recreated what patients with prosopometamorphopsia (PMO) experience when looking at the faces of others.
Three winters ago, on a winter morning, Victor Sharrah woke up and saw his roommate walking into the bathroom. However, when Sharrah looked at his friend’s face, he was horrified because the features stretched out like an “evil face.” In Sharrah’s eyes, the corners of his friend’s mouth and eyes appeared elongated, with pointy ears and deep wrinkles on the forehead. In reality, his friend’s face had not changed; instead, a syndrome had altered Sharrah’s perception. He was terrified because the same thing happened when he looked at the faces of others.
The distorted face that Sharrah sees when looking at people. (Photo: Antônio Mello).
“I tried to explain to my roommate what I was seeing, and he thought I was crazy,” Sharrah shared. “Imagine waking up one morning and suddenly everyone in the world looks like characters from a horror movie.”
Now 59 years old and living in Clarksville, Tennessee, Sharrah was diagnosed with prosopometamorphopsia (PMO), a very rare neurological disorder that makes human faces appear distorted. Since 1904, there have been fewer than 100 documented cases of the disease, and many doctors have never heard of it. However, Sharrah’s case may raise awareness of this mysterious syndrome and provide insights into the lives of those with PMO. For the first time, researchers have been able to create a digital simulation of what a distorted face looks like to someone with PMO like Sharrah, with their findings published in The Lancet on March 23, according to Smithsonian.
Faces only appear distorted when Sharrah looks directly at people. When he sees a face in a photograph or on a computer screen, the images seem entirely normal. This difference allows researchers to use photo editing software to recreate what Sharrah sees. They did this by showing Sharrah a picture of a person’s face while that person stood in the same room with him. As he described the differences between the photograph and the real person, the research team adjusted the image until it matched Sharrah’s description.
The symptoms of PMO vary significantly from person to person. Faces may appear swollen, pale, or have bizarre patterns, while distinctive features may shift to other areas of the face. When looking in a mirror, the patient’s own face may also appear distorted. Therefore, while the edited images represent what Sharrah sees when looking at others’ faces, they may not match the experiences of other PMO patients. However, the images are very useful for helping people understand the type of distortion that patients may perceive, according to Jason Barton, a neurologist at the University of British Columbia in Canada, who did not participate in the research.
Doctors often confuse PMO with mental health syndromes such as schizophrenia or other psychiatric disorders. Although there is some overlap in symptoms, a major difference is that patients with PMO do not believe the world is actually distorted; they are aware that their perception is different, according to co-author of the study Antônio Mello, a cognitive psychologist and neuroscientist at Dartmouth College.
“Many people hesitate to mention their symptoms for fear that others will think the distortions are signs of a mental disorder,” said Brad Duchaine, a psychologist and brain scientist at Dartmouth College. For many, PMO symptoms disappear within a few days or weeks. But for some individuals like Sharrah, they can last for years.
Researchers are unclear about what causes PMO, although it is suspected to result from issues in the brain’s face-processing areas. Some patients develop PMO after a stroke, infectious disease, tumor, or head injury, while others develop it spontaneously without a clear explanation.
For Sharrah, four months before the symptoms began, he suffered from carbon monoxide poisoning. More than a decade prior, he had sustained a severe head injury after falling backward and hitting his head on the floor. However, in his case, adjusting the light color to a specific shade of green helps him see faces normally.
Researchers hope that this new paper will assist doctors in accurately diagnosing PMO. They also hope that the results of their study will help PMO patients feel less alone.
