Glare and Contrast Sensitivity for Clinicians

There have been greater advances in our knowledge of the visual function and its disabilities in the past 50 years than had accumulated in all of the previous years. This applies not only to the basic science of biochemistry, physiology, physiopathology, and cytopathology but also to the diagnosis and treatment of visual dysfunction and ocular disease. These advances have been aided by a proliferation of ingenious instruments. When I began my residency in ophthalmology at The Wilmer Institute in 1938, one was supposed to learn not only the physiology of vision but also how to diagnose and treat all phases of ophthalmology including disabilities of the orbit, sclera, retina, lens, and cornea. In addition he or she was supposed to understand neuro-ophthalmology, ophthalmic genetics, and so-called uveitis. It soon became evident that no one could adequately comprehend all of these areas and, therefore, most young trainees today take a year or two of fel- lowship in a specialized area following their three-to five-year residency train- ing. Following this they join a group of other ophthalmologists and specialize. Thus, they become more expert in the diagnosis and treatment in a limited area in ophthalmology. When I returned to The Wilmer Institute in 1955 as Head of the Department I was the only full-time member of the staff. To date we have some 28 full-time ophthalmologists working in highly specialized areas of our institution.

Table of Contents:
Foreword by A. Edward Maumenee.- Preface.- Contributors.- Terms and Concepts.- 1 Contrast Sensitivity: A Viewpoint for Clinicians.- Potential Clinical Applications.- Conclusions.- 2 An Introduction to Contrast Sensitivity Testing.- Visual Acuity.- Contrast Sensitivity.- Stimuli for Measuring Contrast Sensitivity.- Methodology of Contrast Sensitivity Testing.- Underlying Mechanisms of Contrast Sensitivity Testing.- Clinical Uses of Contrast Sensitivity Testing.- Clinical Constraints on Psychophysical Methods.- A Note About Glare Testing.- General Conclusions.- 3 Light Scattering: Its Relationship to Glare and Contrast in Patients and Normal Subjects.- Glare and Contrast Sensitivity Testing.- Glare Testers.- Contrast and Glare for Normal Eyes.- 4 Essential Factors in Testing for Glare.- Terms and Concepts.- Experimental Design Considerations.- 5 Contrast Sensitivity and Glare Testing in Corneal Disease.- Basic Mechanisms.- Clinical Applications.- 6 Glare and Contrast Sensitivity in Cataracts and Pseudophakia.- Historical Background.- Contrast Sensitivity Testing and Glare Testing for Cataracts.- Nonsurgical Treatment of Cataracts.- Contrast Sensitivity Testing and Glare Testing in Pseudophakia.- 7 Diabetes Mellitus and Visual Function.- What Is Visual Function?.- Visual Function and Diabetic Retinopathy.- Case Reports.- Discussion.- Conclusion.- 8 New Methods for Diagnosis of Retinal Neural Damage Associated with Primary Open-Angle Glaucoma.- Luminance Contrast Sensitivity.- Color Vision.- Pattern Electroretinography.- Conclusion.- 9 Overview of Contrast Sensitivity and Neuro-ophthalmic Disease.- Abbreviations Used in This Chapter.- Visual Acuity and Contrast Sensitivity.- Measuring Contrast Sensitivity.- Clinical Applications.- Final Comments.- 10 Standards for ContrastAcuity/Sensitivity and Glare Testing.- Contrast Acuity/Sensitivity Testing.- Glare Testing.- Conclusions.- 11 Some Basic Concepts and Field Applications for Lighting, Color, and Vision.- Key Aspects of the Visual Stimulus.- Field Application.- Conclusions.- 12 Contrast in Photography.- Definitions.- Attributes of Photographic Contrast.- Attributes of the Imaging System.- Viewing Conditions.- Image Quality.- Physical Indices of Contrast.- Optimum Gradient.- Flare.- Conclusion.