Contrast sensitivity testing in clinical practice.

A survey of ophthalmic publications carried out using the Medline database revealed that during 1983 the search terms contrast and sensitivity appeared in immediate conjunction within the indexing fields of 74 publications. By 1993, this figure had risen to 325. Though a search conducted in this manner would by no means retrieve all the relevant publications, this fourfold increase would suggest a rapidly emerging field of study. Yet, it is a contention of this perspective that contrast sensitivity testing has, despite the ready availability of apparatus and charts adapted for clinical use, had little or no impact on routine ophthalmic practice. Here we explore the reasons why this test has not fulfilled the role that some had predicted for it. Attention is then focused on those circumstances where assessment of this visual capacity is considered appropriate and an attempt is made to classify the assortment of tests now available for clinical use. Future developments are discussed.