Psychophysics of reading. VI--The role of contrast in low vision.

The effect of contrast on reading performance was measured in 19 low-vision observers with a wide range of visual disorders and degrees of vision loss. The observers read text composed of 6 deg letters, ranging in contrast from 0.96 down to contrast threshold for reading. Reading performance was characterized by two parameters: peak reading rate is the reading rate at maximum contrast, and critical contrast is the contrast at which reading rate drops to half its maximum value. Peak reading rates were lower in observers with central field loss than in observers with intact central vision. In 16 of 19 cases, critical contrasts were higher for low-vision observers than for normal observers (averaging 3.9 times higher), indicating a decreased tolerance to contrast reduction. Values of critical contrast were closely linked to contrast sensitivity for letters (r = 0.87), but did not vary systematically with type of vision loss. Five observers read white-on-black text faster than black-on-white at both high and low contrasts. Four of the five had cloudy ocular media. We attribute this contrast polarity effect to abnormal light scatter in eyes with cloudy media. We examined the hypothesis that our low-vision observers' deviation from normal performance could be characterized (1) by a contrast scaling factor representing an attenuation of effective contrast and (2) that this scale factor could be identified with reduced contrast sensitivity. Such a description provided a good account for subjects with cloudy ocular media, where contrast attenuation results from intraocular light scatter. It provided a first order, but incomplete account for subjects with field loss where contrast attenuation is related to contrast sensitivity losses due to neural factors.