["Glare vision". II. Study of visual acuity of glare sensitive patients in increasing test field luminance]

Sensitivity to glare is an unspecific ophthalmological symptom that can be caused by different anatomical structures; it can be related to optical and to cortical structures, it also can be due to defects in the neuronal mechanisms of the retina that control adaptation processes. In many cases the exact mechanisms are still unknown. Tests of visual acuity in glare sensitive patients with increasing test field luminance reveal-depending on the underlying disease-several types of variations from the normal visual-acuity-function that was determined over a wide range of light intensity from 0.1 to 30,000 cd/m2. Marked changes in the visual acuity-luminance-function at high test field intensities were found primarily in patients with retinal diseases, particularly in disturbances of the cone system. These visual acuity losses at high test field luminances can be explained by major functional impediments of the neuronal adaptive mechanisms at the retinal level. Less apparent were the changes in visual acuity-luminance-function in cases of optic nerve diseases. According to our studies changes in the visual acuity-luminance-function accompanied with high glare sensitivity are most often due to pathological changes in neuronal circuitry of the retina, less often to the effects of stray light. This test therefore can provide an important criterion for establishing the correct diagnosis.