Standard eye tests may miss vision problems in real-world conditions

Standard eye exams may overestimate visual performance, as many individuals with normal vision under ideal conditions show significantly worse visual acuity (VA) in low contrast and low light, according to a poster presentation at ARVO 2025.

The study included 30 adults between the ages of 50 and 71 who were analyzed using a specialized vision chart under varying levels of contrast, brightness, and glare.

Visual acuity significantly declined under reduced contrast and dim lighting. Although participants had good vision in bright, high-contrast conditions (average 20/23) their visual acuity worsened significantly to 20/89 when tested in dim lighting with low contrast and added glare. Glare alone did not have a statistically significant effect.

The findings highlight the importance of testing vision under more realistic conditions, particularly for activities like night driving. The authors recommend including suboptimal conditions in clinical assessments to better gauge real-world visual performance.

Reference
Rosenfield A, et al. The effect of glare, luminance and contrast on visual acuity (VA) in presbyopes. Presented at: ARVO Annual Meeting; May 5-8, 2025; Seattle.