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Seeing beyond acuity
  1. TERRI L LEWIS
  1. Department of Ophthalmology, The Hospital for Sick Children and University of Toronto, 555 University Avenue, Toronto, Ontario, Canada, M5G 1X8

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    What are the effects of uniocular disorders on visual outcome? Are some treatment strategies more effective than others? Has the good eye been compromised? Does the age of onset matter? What is the influence of deprivation versus abnormal competition between an affected eye and a fellow good eye? These are all important questions. In answering these questions, we often turn primarily to the “gold standard”—Snellen acuity. But good vision involves more than being able to decipher small details at high contrast. It also involves sensitivity to objects of low contrast, stereopsis, being able to accurately align easily visible objects, the perception of motion, and a host of other aspects of vision. Studies of animals indicate that some aspects of vision are more susceptible to abnormal visual input than others and that the sensitive period differs for different aspects of vision.1 Thus, a clear understanding of visual outcome requires the assessment of more than just visual acuity. …

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