["Glare vision". I. Physiological principles of vision change with increased test field luminance]

Clinical tests of visual acuity are an important measure of visual function. However visual acuity is usually determined only in narrow range of luminance levels between 160 and 320 cd/m2; therefore losses of visual acuity in other ranges of light intensity can not be detected. In a distance of 80 cm from the patients eyes, Landolt rings of varying sizes were presented on a small test field whose light intensity can be varied between 0.1 and 30,000 cd/m2. Thereby an acuity-luminance-function can be obtained. We studied such functions under different conditions of exposure time both with constant and with increasing luminance of the test field. We found that persons with normal vision can increase their visual acuity with increasing test field luminance up to a range of 5000 cd/m2. The maximum values of visual acuity under optimal lightening conditions lie (varying with age) between 2.2 and 0.9. Under pathological conditions visual acuity falls at high luminances accompanied by sensations of glare. Tests of glare sensitivity as a function of exposure time showed 4 sec to be a critical time of exposure since after 4 sec normal persons just reach their maximum visual acuity at high luminances. The underlying physiological mechanisms lead us to suppose that patients with neuronal light adaptation disturbances display a greater visual loss as a result of decreased time of exposure than those with disturbances in the ocular media. Visual acuity as well as the capacity to increase the patients visual acuity under optimal conditions of lighting were both found to be strongly age-dependent.(ABSTRACT TRUNCATED AT 250 WORDS)