Abstract Number: Esoc2026a1361 ‘Your Face Looks Cartoonish!’ Exploring the Impact of Hemi-Prosopometamorphopsia on Occupational Performance, an Occupational Therapy Perspective

Abstract Background and aims Hemi-prosopometamorphopsia (hemi-PMO) is a rare visual perceptual disorder, whereby facial features appear distorted in half of the face. Accurate facial perception is fundamental to social and emotional functioning, supporting communication, emotional recognition and social interaction. Impaired face perception can significantly limit participation in meaningful occupations. This case aims to highlight the crucial role of occupational therapy in evaluating and addressing hidden impairments post-stroke, optimising occupational engagement. Methods T.P., a 73-year-old male mathematics tutor and photographer sustained multiple infarcts; bilateral occipital lobes, right temporoparietal lobe, right cerebellum, and left thalamus. He was independently mobile with significant cognitive and perceptual impairments. T.P was unable to recognise faces, or facial expressions; faces appeared ‘cartoonish’, with the person's right eye appearing ‘large and penetrating’. Standardised assessment and performance analysis were essential to understand the implications of T.Ps hemi-PMO on independence and safety to return home, particularly regarding potential vulnerability in social situations. Results A person-centred intervention programme focused on developing compensatory strategies and graded exposure to social situations. Utilising a strength-based approach, occupational therapy supported T.P to draw on his local knowledge and interest in people to identify them, compensating for impaired facial recognition. An extended home-visit facilitated skill transfer from hospital to community, enabling T.P. to return home independently. Conclusions Early identification of visuo-perceptual impairments following stroke is critical, particularly when deficits are subtle or hidden. This case demonstrates the value of occupational therapy in translating assessment findings into functional understanding, supporting self-management, and enabling safe return to meaningful activities and independent living. Conflict of interest Rowena Padamsey: nothing to disclose