We describe a patient (NJ), with a progressive visual disturbance, who
showed an impairment in identifying larger visually-presented objects
relative to their smaller counterparts. NJ showed this size effect fo
r line drawings of objects, words and single letters. When presented w
ith large letters comprised of smaller letters and asked to give speed
ed identification responses to either the large or small letters, NJ w
as grossly impaired at identifying the large letter. Additionally, whe
n presented with a context meant to bias responding to either the larg
e or small letter, NJ showed faster and more accurate responding in th
e small direction, but not in the large direction. We interpret these
results as indicative of an impaired 'spotlight' of attention, which i
s deployed across the visual array, and is necessary for providing the
selective visual attention responsible for the integration of visual
features. Published by Elsevier Science Ltd.