Contrast sensitivity from infancy to adulthood and its impact on selected eye diseases Review article
Article Sidebar
Published:
Oct 2, 2025
Keywords:
contrast sensitivity, visual development, amblyopia, glaucoma, age-related macular degeneration
Main Article Content
Abstract
Contrast sensitivity is a key visual function that develops rapidly during infancy and plays a significant role in everyday visual activities. Unlike visual acuity, contrast sensitivity often deteriorates earlier and may remain reduced despite normal visual acuity. This review outlines the developmental trajectory of contrast perception and highlights its clinical importance in selected eye diseases such as glaucoma, age-related macular degeneration, and amblyopia. The article also emphasizes the importance of including contrast sensitivity testing in standard ophthalmic examinations.
Downloads
Download data is not yet available.
Article Details
How to Cite
1.
Witowska Jelen E. Contrast sensitivity from infancy to adulthood and its impact on selected eye diseases. Ophthatherapy [Internet]. 2025Oct.2 [cited 2026Apr.12];12(3):206-12. Available from: https://journalsmededu.pl/index.php/ophthatherapy/article/view/3343
Issue
Section
Diagnostics
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright: Medical Education sp. z o.o. License allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
References
1. Rowe FJ. Clinical orthoptics. 3rd ed. Wiley-Blackwell, Chichester 2012.
2. Tokarzewski T, Ożóg M. Ocena stanu narządu wzroku. In: Optometria. Grosvenor T (ed.). Elsevier Urban & Partner, Wrocław 2011: 177-88.
3. Woods RL, Wood JM. The role of contrast sensitivity charts and contrast letter charts in clinical practice. Clin Exp Optom. 1995; 78(2): 43-57. http://doi.org/10.1111/j.1444-0938.1995.tb00787.x .
4. Shafer BM. The contrast sensitivity story. Glaucoma Today. 2021; July/Aug: 26-8.
5. Witowska-Jeleń E. Contrast sensitivity function - Figures 1-4. 2025. Original material. ORTO-OPTICA.
6. Dekker TM, Schwarzkopf DS, Sereno MI et al. Development of the spatial contrast sensitivity function (CSF) during childhood: analysis of previous findings and new psychophysical data. J Vis. 2020; 20(13): 4. http://doi.org/10.1167/jov.20.13.4.
7. Banks MS. The development of spatial and temporal contrast sensitivity. Curr Eye Res. 1982; 2(3): 181-99.
8. Atkinson J, Braddick O, Moar K. Development of contrast sensitivity over the first 3 months of life in the human infant. Vision Res. 1977; 17(9): 1037-44. http://doi.org/10.1016/0042-6989(77)90007-4.
9. Norcia AM, Tyler CW, Hamer RD. Development of contrast sensitivity in the human infant. Vision Res. 1990; 30(10): 1475-86. http://doi.org/10.1016/0042-6989(90)90028-J .
10. Brown AM, Lindsey DT, Guckes KM. The contrast sensitivity of the newborn human infant. Invest Ophthalmol Vis Sci. 2015; 56(1): 625-32. http://doi.org/10.1167/iovs.14-14757.
11. Braddick O, Atkinson J. Development of human visual function. Vision Res. 2011; 51(13): 1588-609. http://doi.org/10.1016/s0002-9394(00)00623-1.
12. Marrone MC, Burr D, Fiorentini A. Development of contrast sensitivity and acuity of the infant colour system. Proc R Soc Lond B Biol Sci. 1990; 242: 134-9.
13. Dobkins KR, Bosworth RG, McCleery JP. Effects of gestational length, gender, postnatal age, and birth order on visual contrast sensitivity in infants. J Vis. 2009; 9(10): 19.1-21. http://doi.org/10.1167/9.10.19.
14. Good WV, Hou C, Norcia AM. Spatial contrast sensitivity vision loss in children with cortical visual impairment. Invest Ophthalmol Vis Sci. 2012; 53(12): 7730-4. http://doi.org/10.1167/iovs.12-10321.
15. Purves D, Augustine GJ, Fitzpatrick D et al. Neuroscience: Central visual pathways. 2nd ed. Sinauer Associates, Sunderland (MA) 2001: 257-76.
16. Bullier J, Nowak LG. Parallel versus serial processing: new vistas on the distributed organization of the visual system. Curr Opin Neurobiol. 1995; 5(4): 497-503. http://doi.org/10.1016/0959-4388(95)80011-5.
17. Eshraghi H, Abolfathi P, Ameri A. Contrast sensitivity in patients with primary open angle glaucoma. J Glaucoma. 2009; 18(3): 213-8. http://doi.org/10.1097/IJG.0b013e3181815420.
18. Keurten R, Lanzl I, Lämmer R. Association between retinal blood flow and contrast sensitivity in patients with normal-tension glaucoma. Graefes Arch Clin Exp Ophthalmol. 2021; 259(6): 1503-12. http://doi.org/10.1007/s00417-021-05126-5.
19. Thacur S, Singh A, Sharma R. Role of contrast sensitivity testing in early diagnosis of glaucoma. Indian J Ophthalmol. 2017; 65(10): 859-64. http://doi.org/10.4103/ijo.IJO_1131_16.
20. Richman J, Spaeth GL, Wirostko B et al. Contrast sensitivity and visual field loss in glaucoma. Br J Ophthalmol. 2010; 94(10): 1430-3. http://doi.org/10.1136/bjo.2009.171504.
21. Raol S, Srinivasan K, Vijaya L. Evaluation of Spaeth-Richman Contrast Sensitivity Test in glaucoma detection. Indian J Ophthalmol. 2020; 68(9): 1845-51. http://doi.org/10.4103/ijo.IJO_1013_20.
22. Zulauf M, Flammer J. Correlation between contrast sensitivity and visual field in glaucoma. Br J Ophthalmol. 1993; 77(4): 228-32. http://doi.org/10.1136/bjo.77.4.228.
23. Lavah M, Levkovitch-Verbin H. Foveal dysfunction in glaucoma patients with normal visual acuity. Graefes Arch Clin Exp Ophthalmol. 2011; 249(8): 1153-8. http://doi.org/10.1007/s00417-011-1639-0.
24. Fatehi N, Nowroozizadeh S, Nassiri N et al. Association between macular thickness and contrast sensitivity in glaucoma. J Ophthalmic Vis Res. 2017; 12(1): 9-15. http://doi.org/10.4103/jovr.jovr_5_16.
25. Falcao-Reis FM, O'Donoghue E, Buceti R et al. Peripheral colour contrast sensitivity in glaucoma and ocular hypertension. Eye. 1991; 5(Pt 5): 601-7. http://doi.org/10.1038/eye.1991.105.
26. Roh H. Contrast sensitivity and quality of life in patients with age-related macular degeneration. Invest Ophthalmol Vis Sci. 2018; 59(9): AMD40-46. http://doi.org/10.1167/iovs.17-23463.
27. Ridder WH, Zhang Z, Huang S et al. Contrast sensitivity and visual function in intermediate age-related macular degeneration under mesopic and photopic conditions. Invest Ophthalmol Vis Sci. 2021; 62(4): 8. http://doi.org/10.1167/iovs.62.4.8.
28. Ou WC, Patel SN, Domalpally A et al. Contrast sensitivity in intermediate and advanced age-related macular degeneration: associations with photopic and mesopic function. Retina. 2021; 41(1): 68-75. http://doi.org/10.1097/IAE.0000000000002813.
29. Thang D, Zhou J. Age and stimulus type effects on contrast sensitivity: differences between first- and second-order stimuli. Vision Res. 2009; 49(17): 1894-901. http://doi.org/10.1016/j.visres.2009.05.007.
30. Keane PA, Liakopoulos S, Jivrajka RV et al. Evaluation of optical coherence tomography retinal thickness parameters for use in clinical trials for neovascular age-related macular degeneration. Invest Ophthalmol Vis Sci. 2010; 51(3): 1368-75. http://doi.org/10.1167/iovs.09-3932.
31. Ittiara S, Heeralall N, Kythreotis P et al. Colour vision deficits in age-related macular degeneration. Br J Ophthalmol. 2020; 104(5): 709-13. http://doi.org/10.1136/bjophthalmol-2018-313547.
32. Dorr M, Elze T, Wang H et al. New precision metrics for contrast sensitivity testing. Vision Res. 2019; 148: 1-12. http://doi.org/10.1016/j.visres.2018.10.008.
33. Suliman IA, Ahmed Ali M. The effect of amblyopia on contrast sensitivity, color vision, and stereoacuity. Al-Basar Int J Ophthalmol. 2017; 4: 54-7. http://doi.org/10.4103/bijo.bijo_5_17.
34. Wang H, Lesmes LA, Elze T et al. Development of contrast sensitivity across the lifespan using the quick CSF method. J Vis. 2017; 17(6): 1-25. http://doi.org/10.1167/17.6.1.
35. Chatzistefanou KI, Theodossiadis GP, Damanakis AG et al. Contrast sensitivity in amblyopia: the fellow eye of untreated and successfully treated amblyopes. J AAPOS. 2005; 9(5): 468-74. http://doi.org/10.1016/j.jaapos.2005.05.006.
36. Pang Y, Allen M, Robinson J et al. Contrast sensitivity in anisometropic amblyopia. Optom Vis Sci. 2019; 96(9): 690-9. http://doi.org/10.1097/OPX.0000000000001422.
37. Kosovicheva A, Taroyan NA, Bridge H. Preservation of low spatial frequency contrast sensitivity in amblyopia. Vision Res. 2019; 162: 1-10. http://doi.org/10.1016/j.visres.2019.06.001.
38. Mayer MJ, Kim CB, Svingos A et al. Short-term adaptation to blurred and sharpened vision in contrast sensitivity. Vision Res. 2020; 170: 1-9. http://doi.org/10.1016/j.visres.2020.03.003.
2. Tokarzewski T, Ożóg M. Ocena stanu narządu wzroku. In: Optometria. Grosvenor T (ed.). Elsevier Urban & Partner, Wrocław 2011: 177-88.
3. Woods RL, Wood JM. The role of contrast sensitivity charts and contrast letter charts in clinical practice. Clin Exp Optom. 1995; 78(2): 43-57. http://doi.org/10.1111/j.1444-0938.1995.tb00787.x .
4. Shafer BM. The contrast sensitivity story. Glaucoma Today. 2021; July/Aug: 26-8.
5. Witowska-Jeleń E. Contrast sensitivity function - Figures 1-4. 2025. Original material. ORTO-OPTICA.
6. Dekker TM, Schwarzkopf DS, Sereno MI et al. Development of the spatial contrast sensitivity function (CSF) during childhood: analysis of previous findings and new psychophysical data. J Vis. 2020; 20(13): 4. http://doi.org/10.1167/jov.20.13.4.
7. Banks MS. The development of spatial and temporal contrast sensitivity. Curr Eye Res. 1982; 2(3): 181-99.
8. Atkinson J, Braddick O, Moar K. Development of contrast sensitivity over the first 3 months of life in the human infant. Vision Res. 1977; 17(9): 1037-44. http://doi.org/10.1016/0042-6989(77)90007-4.
9. Norcia AM, Tyler CW, Hamer RD. Development of contrast sensitivity in the human infant. Vision Res. 1990; 30(10): 1475-86. http://doi.org/10.1016/0042-6989(90)90028-J .
10. Brown AM, Lindsey DT, Guckes KM. The contrast sensitivity of the newborn human infant. Invest Ophthalmol Vis Sci. 2015; 56(1): 625-32. http://doi.org/10.1167/iovs.14-14757.
11. Braddick O, Atkinson J. Development of human visual function. Vision Res. 2011; 51(13): 1588-609. http://doi.org/10.1016/s0002-9394(00)00623-1.
12. Marrone MC, Burr D, Fiorentini A. Development of contrast sensitivity and acuity of the infant colour system. Proc R Soc Lond B Biol Sci. 1990; 242: 134-9.
13. Dobkins KR, Bosworth RG, McCleery JP. Effects of gestational length, gender, postnatal age, and birth order on visual contrast sensitivity in infants. J Vis. 2009; 9(10): 19.1-21. http://doi.org/10.1167/9.10.19.
14. Good WV, Hou C, Norcia AM. Spatial contrast sensitivity vision loss in children with cortical visual impairment. Invest Ophthalmol Vis Sci. 2012; 53(12): 7730-4. http://doi.org/10.1167/iovs.12-10321.
15. Purves D, Augustine GJ, Fitzpatrick D et al. Neuroscience: Central visual pathways. 2nd ed. Sinauer Associates, Sunderland (MA) 2001: 257-76.
16. Bullier J, Nowak LG. Parallel versus serial processing: new vistas on the distributed organization of the visual system. Curr Opin Neurobiol. 1995; 5(4): 497-503. http://doi.org/10.1016/0959-4388(95)80011-5.
17. Eshraghi H, Abolfathi P, Ameri A. Contrast sensitivity in patients with primary open angle glaucoma. J Glaucoma. 2009; 18(3): 213-8. http://doi.org/10.1097/IJG.0b013e3181815420.
18. Keurten R, Lanzl I, Lämmer R. Association between retinal blood flow and contrast sensitivity in patients with normal-tension glaucoma. Graefes Arch Clin Exp Ophthalmol. 2021; 259(6): 1503-12. http://doi.org/10.1007/s00417-021-05126-5.
19. Thacur S, Singh A, Sharma R. Role of contrast sensitivity testing in early diagnosis of glaucoma. Indian J Ophthalmol. 2017; 65(10): 859-64. http://doi.org/10.4103/ijo.IJO_1131_16.
20. Richman J, Spaeth GL, Wirostko B et al. Contrast sensitivity and visual field loss in glaucoma. Br J Ophthalmol. 2010; 94(10): 1430-3. http://doi.org/10.1136/bjo.2009.171504.
21. Raol S, Srinivasan K, Vijaya L. Evaluation of Spaeth-Richman Contrast Sensitivity Test in glaucoma detection. Indian J Ophthalmol. 2020; 68(9): 1845-51. http://doi.org/10.4103/ijo.IJO_1013_20.
22. Zulauf M, Flammer J. Correlation between contrast sensitivity and visual field in glaucoma. Br J Ophthalmol. 1993; 77(4): 228-32. http://doi.org/10.1136/bjo.77.4.228.
23. Lavah M, Levkovitch-Verbin H. Foveal dysfunction in glaucoma patients with normal visual acuity. Graefes Arch Clin Exp Ophthalmol. 2011; 249(8): 1153-8. http://doi.org/10.1007/s00417-011-1639-0.
24. Fatehi N, Nowroozizadeh S, Nassiri N et al. Association between macular thickness and contrast sensitivity in glaucoma. J Ophthalmic Vis Res. 2017; 12(1): 9-15. http://doi.org/10.4103/jovr.jovr_5_16.
25. Falcao-Reis FM, O'Donoghue E, Buceti R et al. Peripheral colour contrast sensitivity in glaucoma and ocular hypertension. Eye. 1991; 5(Pt 5): 601-7. http://doi.org/10.1038/eye.1991.105.
26. Roh H. Contrast sensitivity and quality of life in patients with age-related macular degeneration. Invest Ophthalmol Vis Sci. 2018; 59(9): AMD40-46. http://doi.org/10.1167/iovs.17-23463.
27. Ridder WH, Zhang Z, Huang S et al. Contrast sensitivity and visual function in intermediate age-related macular degeneration under mesopic and photopic conditions. Invest Ophthalmol Vis Sci. 2021; 62(4): 8. http://doi.org/10.1167/iovs.62.4.8.
28. Ou WC, Patel SN, Domalpally A et al. Contrast sensitivity in intermediate and advanced age-related macular degeneration: associations with photopic and mesopic function. Retina. 2021; 41(1): 68-75. http://doi.org/10.1097/IAE.0000000000002813.
29. Thang D, Zhou J. Age and stimulus type effects on contrast sensitivity: differences between first- and second-order stimuli. Vision Res. 2009; 49(17): 1894-901. http://doi.org/10.1016/j.visres.2009.05.007.
30. Keane PA, Liakopoulos S, Jivrajka RV et al. Evaluation of optical coherence tomography retinal thickness parameters for use in clinical trials for neovascular age-related macular degeneration. Invest Ophthalmol Vis Sci. 2010; 51(3): 1368-75. http://doi.org/10.1167/iovs.09-3932.
31. Ittiara S, Heeralall N, Kythreotis P et al. Colour vision deficits in age-related macular degeneration. Br J Ophthalmol. 2020; 104(5): 709-13. http://doi.org/10.1136/bjophthalmol-2018-313547.
32. Dorr M, Elze T, Wang H et al. New precision metrics for contrast sensitivity testing. Vision Res. 2019; 148: 1-12. http://doi.org/10.1016/j.visres.2018.10.008.
33. Suliman IA, Ahmed Ali M. The effect of amblyopia on contrast sensitivity, color vision, and stereoacuity. Al-Basar Int J Ophthalmol. 2017; 4: 54-7. http://doi.org/10.4103/bijo.bijo_5_17.
34. Wang H, Lesmes LA, Elze T et al. Development of contrast sensitivity across the lifespan using the quick CSF method. J Vis. 2017; 17(6): 1-25. http://doi.org/10.1167/17.6.1.
35. Chatzistefanou KI, Theodossiadis GP, Damanakis AG et al. Contrast sensitivity in amblyopia: the fellow eye of untreated and successfully treated amblyopes. J AAPOS. 2005; 9(5): 468-74. http://doi.org/10.1016/j.jaapos.2005.05.006.
36. Pang Y, Allen M, Robinson J et al. Contrast sensitivity in anisometropic amblyopia. Optom Vis Sci. 2019; 96(9): 690-9. http://doi.org/10.1097/OPX.0000000000001422.
37. Kosovicheva A, Taroyan NA, Bridge H. Preservation of low spatial frequency contrast sensitivity in amblyopia. Vision Res. 2019; 162: 1-10. http://doi.org/10.1016/j.visres.2019.06.001.
38. Mayer MJ, Kim CB, Svingos A et al. Short-term adaptation to blurred and sharpened vision in contrast sensitivity. Vision Res. 2020; 170: 1-9. http://doi.org/10.1016/j.visres.2020.03.003.