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Assessment of visual contrast sensitivity in biotoxin-exposed individuals using four testing methods

Ingrid Astrid Jimenez-Barbosa1, Sean Di Lizio2,3, Seong Beom Ahn4

  • 1School of Optometry and Vision Science, The University of New South Wales, Sydney, Australia.

Annals of Medicine
|April 6, 2026
PubMed
Abstract

Insights

Digital visual contrast sensitivity (VCS) tests effectively identify biotoxin exposure, unlike traditional methods. This research aids in diagnosing neurological and visual issues linked to environmental toxins.

Area of Science:

  • Environmental Health
  • Neuroscience
  • Ophthalmology

Background:

  • Environmental biotoxins, like mould, are associated with neurological and visual impairments.
  • Impaired visual contrast sensitivity (VCS) is a potential biomarker for biotoxicity.
  • This study evaluated VCS tests for detecting deficits in individuals exposed to biotoxins.

Purpose of the Study:

  • To compare the efficacy of four different VCS tests in identifying visual deficits in individuals with suspected biotoxin exposure.
  • To assess the utility of VCS testing as a biomarker for environmental biotoxin exposure.
  • To correlate VCS deficits with neurotoxicity symptoms and pupil size.

Main Methods:

  • Twenty-eight biotoxin-exposed individuals and 30 controls underwent four VCS tests: Shoemaker handheld chart, Online Contrast Sensitivity Test (OCST™), Clinic CSF App, and an Experimental VCS test.
  • Neurotoxicity symptoms were evaluated using the modified Q16 questionnaire.
  • Pupil size was measured under standard lighting conditions.

Main Results:

  • Biotoxin-exposed participants exhibited significantly smaller pupil diameters and higher neurotoxicity scores compared to controls.
  • Reduced contrast sensitivity was observed in exposed individuals exclusively on digital VCS tests.
  • The Experimental VCS test showed the highest diagnostic performance (100% sensitivity), followed by OCST™ and Clinic CSF App; the Shoemaker chart was ineffective.

Conclusions:

  • Digital VCS testing, alongside symptom questionnaires, serves as a practical and effective method for detecting visual and neurological impairments in suspected biotoxin exposure cases.
  • These findings underscore the importance of utilizing advanced diagnostic tools for environmental health assessments.
Keywords:
Contrast sensitivitybiomarkerschronic inflammatory response syndromeneurotoxicity

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