Nordan’s Perspective

JANUARY 2006 I CATARACT & REFRACTIVE SURGERY TODAY I 19 Contrast acuity testing continues to be paramount now that presbyopic correction is part of our clinical armamentarium. Key is how much the correction of presbyopia degrades distance visual function. Until now, this question has not been answered adequately. In general, I am astounded that we embarked on keratorefractive surgery 25 years ago but still do not have a clinically relevant, widely accepted method of documenting a patient’s functional acuity in an effort to compare the outcomes of the various methods of refractive surgery. Contrast acuity testing is the means for such documentation and comparison. It is similar to the Snellen test, simple to administer, and easy to interpret. Moreover, testing can be clinically relevant. This article describes the system of functional contrast acuity testing that Rick Baker, OD, of Houston and I are formalizing. Certainly, other systems can be devised. The strong imperative, however, is to institute such a system universally and quickly, or else we will continue to perform surgery without an objective means of describing its result.