Psychophysical measurements of contrast thresholds for sinusoidal gratings of variable frequency were made in normal controls and in patients with macular disease. Normal controls showed a U-shaped contrast sensitivity function comparable with previous reports. Patients with relatively well conserved visual acuity showed a marked impairment in contrast sensitivity for targets of high and intermediate spatial frequencies, while patients with more advanced disease showed a pronounced impairment across a larger spectrum of frequencies. Our findings provide insight into the visual difficulties of daily life of patients with macular disease. The determination of contrast sensitivity seems to be an important and very sensitive tool for the detection of early disturbances.