Impaired distance perception and size constancy following bilateral occipitoparietal damage

Accurate distance perception depends on the processing and integration of a variety of monocular and binocular cues. Dorsal stream lesions can impair this process, but details of this neurocognitive relationship remain unclear. Here, we tested a patient with bilateral occipitoparietal damage and severely impaired stereopsis. We addressed four related questions: (1) Can distance and size perception survive limitations in perceiving monocular and binocular cues? (2) Are egocentric (self-referential) and allocentric (object-referential) distance judgments similarly impaired? (3) Are distance measurements equally impaired in peripersonal and extrapersonal space? (4) Are size judgments possible when distance processing is impaired? The results demonstrate that the patient's lesions impaired both her distance and size perception, but not uniformly. Her performance when using an egocentric reference frame was more impaired than her performance when using an allocentric reference frame. Likewise, her distance judgments in peripersonal space were more impaired than those in extrapersonal space. The patient showed partial preservation in size processing of novel objects even when familiar size cues were removed.