Abstract

Visual field reversibility, not uncommon in treated chronic glaucoma, is well-documented in individuals and groups. Contrast sensitivity is proving to be valuable for diagnosing and treating glaucoma suspects and patients. Presented here are cases of substantial contrast sensitivity reversals, measured with the Vistech Consultants Vision Contrast Test System (VCTS), in patients receiving topical drug therapy and, in one case, trabeculotomy. The phenomenon of predominately midfrequency contrast sensitivity losses in glaucoma patients is evident. These patients exhibit significant posttherapeutic changes in their contrast sensitivity curves. Contrast sensitivity deficits appear to be reversible and may even be anticipated in response to treatment. Possible visual mechanisms behind the contrast sensitivity changes are discussed. Furthermore, the inherent lack of midfrequency sensitivity of low-contrast optotypes suggests caution in their use to evaluate contrast sensitivity losses and therapeutic changes in glaucoma patients. The contrast sensitivity reversals, which may or may not be accompanied by visual field reversals, can occur in both those patients treated with drugs and those who undergo surgery. It is apparent that changes in contrast sensitivity and visual fields can provide useful clinical information to evaluate glaucoma patients and their responses to therapy.

© 1988 Optical Society of America