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High myopia results in stretching of the retina. We expected this stretching to impair visual function. Accordingly, we tested static and dynamic spatial contrast sensitivity and temporal modulation sensitivity at photopic, mesopic, and scotopic luminance levels. None of these functions differed significantly for high myopes (6 to 10 D) relative to age-matched normals. We conclude that retinal stretching need not induce visual deficits.

Three adult amblyopic patients who underwent vision training involving monocular occlusion of the nonamblyopic eye and stimulation of the amblyopic eye using simple fixation exercises and a spinning grating procedure were evaluated using five different types of acuity testing and two methods of contrast sensitivity. It was found that contrast sensitivity and isolated Landolt C acuity improved sooner and to a greater extent than the more complex visual acuity tasks. One patient who improved only on the simpler tasks complained that the enhanced contrast due to training made vision in that eye less acceptable because it was more confusing. The results show that multiple measures of visual acuity and contrast sensitivity are necessary to adequately monitor the effects of occlusion therapy.

Contrast sensitivity functions (CSF) provide a better measure of visual function than traditional acuity tests. The use of CSFs with cataract and contact lens patients as well as with patients suspected to have glaucoma or retrobulbar neuritis is discussed. Various methods for determining the CSF are discussed, with the conclusion that the newly developed Arden plates are best for use in clinical practice.

The use of Contrast Sensitivity Functions (CSF's) in vision evaluation has been explored for several years. Although theoretically superior to Snellen acuity and similar measures, the use of CSF is not widespread. A review of some of the clinical conditions in which CSF's have been used is followed by a discussion of the problems involved in their measurement and interpretation.

The presence of visual field anomalies was measured using Goldmann kinetic perimetry in twelve patients, age 7 to 39 with Gilles de la Tourette syndrome. Refraction to the cupola was carefully controlled. The visual acuity of the group was good to excellent. Visual field alterations were prechiasmal, generally non-symmetric, and best described as arcuate defects, steps, baring of the blind spot and enlargement of the blind spot. Central fields were most commonly affected, i.e., I/2e to I/1B isopters. There was no evidence of glaucoma in any of the patients although two patients exhibited keratoconus and another one manifested moderate to high astigmatism. Visual involvement other than ocular and lid tics have not been reported in Tourette syndrome. This research represents clear evidence of additional physical components in this condition. Automated visual field measurements are not recommended in this population because of the presence of non-predictable tic and vocal behavior (both may result in head/eye movements). Suppression of tic behavior can be very fatiguing. (Eight of twelve of the patients reported exhibited signs of marked fatigue during testing.)

The axial elongation of high myopia is known to induce tangential stretching forces on the retina. Such forces might be expected to compromise retinal circuitry and thus affect the temporal and spatial contrast sensitivity function. In fact, we find that simple high myopes have normal contrast sensitivity for stationary gratings, moving gratings, and uniform field flicker. This suggests that, unlike many other retinal disease processes, the high myope's retina retains its normal integrity until the outer retina is compromised.