DISTRI1SUTION STATEMENT · 2011-05-14 · contrast sensitivity function (CSF) and soft contact lens wear. Contrast sensitivity was measured at six spatial frequencies for nineteen

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* ~ Effects of Soft Contact Lenses on Contrast THESIS/0191At1ONS Sensitivity

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S David L. Kirkpatrick

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ABSTRACT

This study attempts to resolve the conflicting literature relative to

contrast sensitivity function (CSF) and soft contact lens wear. Contrast

sensitivity was measured at six spatial frequencies for nineteen subjects

(38 eyes) when corrected with both spectacles and soft lenses. Measured

amounts of residual astigmatism and/or sphere were corrected using a trial

frame and lenses. Additionally, data was evaluated on more than one occa-

sion in order to investigate the effect of time upon visual performance

with the lenses. The results indicate a measurable decrease in contrast

sensitivity for only the highest of the spatial frequencies tested (22.8

cycles/degree) when soft lenses were worn. For those eyes demonstrating a

clinically significant decrease in contrast sensitivity, responsibility

appears to be shared by both the contact lens and the cornea. There were

no significant changes in CSF over time. .

IAccession Far.

DTIC TAB

Justl'ictjo .

By

/v \ l .... eCbiaA ,1 ad/o,Dist S

AFIT/CI/NR 84-IT

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RESEARCH TITLE: Effpcrt nf Snft Cnntact Lenses On Contrast Sensitivity

AUTHOR: David L. Kirkpatrick

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EFFECTS OF SOFT CONTACT LENSES ON

CONTRAST SENSITIVITY

e21 ITO

I

EFFECTS OF SOFT CONTACT LENSES ON

1 CONTRAST SENSITIVITY

t

A Thesis Presented to

I the Faculty of the Graduate School of

Pacific University

I

t

In Partial Fulfillment

of the Requirements for the Degree

Master of Science

in Clinical Optometry (Management Track)

by

* David L. Kirkpatrick, O.D.

April 1983

"

APPROVED

Niles Roth, O.D., Ph.D., Coordinator of Graduate Studies

LoiS yd .S MS, hD

UIV

I rd rb* .. ..

Dieep f dut tde

Acknowledgements

My sincerest thanks and appreciation go to both my advisor, Doctor

John Roggenkamp, for his ideas and guidance, and Doctor Niles Roth, for his

assistance and encouragement throughout the course of this study. I wisht

to also give special thanks to Doctors Lori Rynd and Don West for their

counsel and advice.

Thanks need also be extended to the United States Air Force for allow-

ing me both the opportunity and the funding for this graduate education,

and both Barnes Hind Hydrocurve, Inc. and Bausch & Lomb, Inc. whose support

and generosity made this study possible.

My last word of acknowledgement delightedly goes to my wife Noreen who

has shared my "highs" and endured my "lows" throughout this study. Thank

you all.

Si

!S

TABLE OF CONTENTS

Abstract .. ................ ............ .....

List of Figures.................... ........... .. .. .. . . ...

* List of Tables.................... .. .. ...... . .. .. .. .. . . ...

Introduction and Background.............. . . .. .. .. .. .. .....

Significance of Study. ............... ......... 3 -

*Review of Literature .. ............... ......... 4

Statement of Problem ............... .......... 7

Subjects .. ............... ............... 9

*Material and Methods .. ............... ......... 14

Treatment of Data .. ......................... 24

Results .. .............................. 27

9Discussion and Conclusion. ................ ...... 35

References. .. ............................ 38

Appendices. .. ............................ 40

A. Photometric Measurement of Monitor Display (Peak Contrast). 41

B. "Calibration Drift" Error Analysis. ............. 42

C. Photometric Measurement of Monitor Display*(Average Luminance). ................ ... 43

D. Photometric Measurement of Peripheral Surround .. ...... 44

E. CS-2000 Program Format .. ............... ... 45

* F. Instrument Reliability Testing (Test-Retest) .. ....... 46

4 1

I

G. SANVAR Program ........ ..................... .... 47tH. "t" Test (Related Measures) Program ... ........... ... 48

I. Data Collection Sheets (Descriptive) ... ........... ... 49(Individual Descriptive Sheets arenumbered 49A - 49S)

t

J. Data Collection Sheets (Test Results) ............. .... 50(Individual Test Results arenumbered 50A - 50S)

K. Definitions of Terms ....... ................... ... 51

/

.1

ABSTRACT

This study attempts to resolve the conflicting literature relative to

contrast sensitivity function (CSF) and soft contact lens wear. Contrast

sensitivity was measured at six spatial frequencies for nineteen subjects

(38 eyes) when corrected with both spectacles and soft lenses. Measured

amounts of residual astigmatism and/or sphere were corrected using a trial

frame and lenses. Additionally, data was evaluated on more than one occa-

sion in order to investigate the effect of time upon visual performance

with the lenses. The results indicate a measurable decrease in contrast

sensitivity for only the highest of the spatial frequencies tested (22.8

cycles/degree) when soft lenses were worn. For those eyes demonstrating a

clinically significant decrease in contrast sensitivity, responsibility

appears to be shared by both the contact lens and the cornea. There were

no significant changes in CSF over time.

-

LIST OF FIGURES

Figure 1: The CS-2000 Contrast Sensitivity TestingSystem (photograph) ...... ................. ... 15

Figure 2: Examples of Sine Wave Gratings (photograph) ..... .. 16

Figure 3: Display Monitor and White Poster BoardSurround (photograph) ........ ................ 18

Figure 4: Spatial Frequencies Used to DetermineContrast Sensitivity Function (CSF)(photograph) ....... .................... ... 22

Figure 5: Graph of Contrast Sensitivity Function (CSF) . . .. 30

:1

LIST OF TABLES

Table 1: Data Describing the patient population ... ....... 10

Table 2: Significance study (unidirectional "t" testfor related measures) comparing contrast

* sensitivity data. Data taken with contactlenses (residual error corrected) at dispens-ing, one week, and one month are compared tothat taken with spectacles before contactlens fitting (baseline data) ...... ............ 28

Table 3: Mean contrast sensitivity (+I standard de-viation with spectacle or soft contact lens

correction ....... .................... ... 29

Table 4: Significance study (unidirectional "t" testfor related measures) comparing contrastsensitivity data for eyes demonstrating aclinically significant decrease in contrastsensitivity. Data taken with contact lenses(residual error corrected) at dispensing, oneweek, and one month are compared to thattaken immediately following contact lensremoval ........ ....................... .... 33

Table 5: Significance study (unidirectional "t" testfor related measures) comparing contrastsensitivity data for eyes demonstrating aclinically significant decrease in contrastsensitivity. Data taken immediately follow-ing contact lens removal at dispensing, oneweek, and one month are compared to thattaken with spectacles before contact lensfitting (baseline data) .... ............... .... 34

$

iii

p

J1

INTRODUCTION AND BACKGROUND

Despite recent advances in the field of soft contact lenses, many

problems remain. One such problem is the decrease in "visual function"

t often found in patients fit with soft contact lenses. Despite their abil-

ity to achieve visual acuity comparable to that with their spectacle

lenses, these patients frequently complain that their new vision is "not

tquite as sharp" as it previously had been through their glasses.

Determination of the Contrast Sensitivity Function (CSF) of the human

visual system has been shown to be clinically relevant in the evaluation of

overall visual performance.1-21 This is especially true for those condi-

tions which compromise the patient's ability to see images yet spare the

ability to recognize fine detail, i.e. patients complain of "hazy" vision

yet Snellen acuities and related measures, which depend on resolution of

fine detail at contrast ratios approximating 100%, are normal.

There are two independent components to the contrast sensitivity

function.5 One is an optical component which is affected by optical aber-

rations, diffraction, and scatter which degrade the retinal image. The

second is a neural component which, due to anatomical and physiological

limitations and interactions, affects the processing of information within

the retina and visual pathways. Abnormalities in CSF are usually related

to defects in either the optical (corrective lens-eye) system, which affect

contrast sensitivity primarily for high spatial frequency perception, or

the retina-brain system, which affect contrast sensitivity primarily for

low spatial frequency perception. The neural component of the CSF should

I r: theoretically remain unaffected by optical changes which affect only the

quality of the retinal image. Abnormalities of the CSF in healthy contact

... ..

2

* lens patients are therefore assumed to be indicative of an aberration or

defect within the optical system.

Literature to date seems to indicate that the wear of soft contact

* lenses does indeed affect the contrast sensitivity function.2 1- 2 5 For the

most part however, these studies are characterized by an insufficiency of

subjects, a lack of controls, and an over-interpretation and over-generali- 1"zation of the findings. At present, no attempt has been successful in $explaining the causitive agent of the effect on contrast sensitivity.

I.I

I.i

3

SIGNIFICANCE

Information from a study which not only establishes correlation be-

tween the CSF and soft contact lens wear, but which also indicates that

aspect of the optical system (contact lens or cornea) responsible for these

changes, is essential in the initial approach to this problem. Once this

has been accomplished the results will be two-fold. First, the direction of

* future studies will be more clearly defined, and second, the contact lens

practitioner will gain needed insight into this common and confusing prob-

lem.

Due to the former complexities of the required apparatus and test

procedure, contrast sensitivity testing had been limited solely to the

research laboratory. Emerging interest in CSF as a clinical tool for eye

care practitioners is spurred, however, by the recent availability of more

simplified testing procedures. These are the CS2000 Contrast Sensitivity

Testing System (available through Nicolet Biomedical Instruments), the

Cadwell CTS 5000 (available through Cadwell Laboratories) and the Arden

Photographic Plates (available from American Optical Co.). In light of

these new capabilities and armed with the information provided by this

study, the contact lens practitioner could facilitate the diagnosis and

treatment of visual dysfunctions induced by soft contact lenses.

!.

S

4

REVIEW OF THE LITERATURE

Based on a study comparing visual acuity in both hard and soft contact

lens wearers, Wechsler predicts that approximately 25% of this population

will show a decrease in measured acuity even when refractive error is

completely corrected. 2 6 This determination was made by comparing best

spectacle acuity with that measured with the contact lenses plus over-

* refraction. Another interesting finding revealed in this study was that

the decrease in visual acuity of soft contact lens wearers is usual l y

greater than that of hard lens wearers.

Possible explanations for this phenomenon are many. Often a decrease

in acuity can be explained by the clinical observation that the contact

lens surface for both hard and soft lenses is poorer than the normal

corneal surface. Westheimer, however, has written that spherical aberra-

tion is the most important aberration in contact lenses.27 Bauer has

recently demonstrated that a soft contact lens having spherical surfaces

produces significant longitudinal spherical aberrations as compared to

spectacle lens aberrations. 2 8 He has suggested that soft contact lenses

having at least one properly selected aspherical surface could be designed

and made to correct for longitudinal spherical aberrations as compared to

spectacle lens aberrations. Following this reasoning, it is possible,

depending upon the topography of the individual cornea, that the retinal

image may be enhanced or degraded by the contact lens.2 6

Millodot has described the effect of luminance reduction on contact

lens wearers. 2 9 He notes, "...that the visual acuity of myopic subjects

* Odeteriorates more rapidly with contact lenses than with glasses as lumi-

nance decreases." The effects, therefore, of luminance reduction, spheri-

'p

5

cal aberration, and lens surface defects may individually or in combination

be held responsible for a decrease in visual function as related to soft

contact lens wear.

t An alternative, worthy of consideration in decreased visual function,

is the contribution of the cornea. Using tests of contrast sensitivity,

visual loss has been demonstrated to result from both cornea" distortion

and edema.10 '"I Thus the practitioner should be aware that a decrease in

visual function can occur for any of the following reasons: 1) the inherent

qualities of the contact lens, i.e. wettability, surface defects or de-

posits, aberrations, luminance reduction, etc., 2) corneal changes induced

by the contact lens, or 3) a combination of both 1 and 2.

Contrast sensitivity functions are believed to provide a more defini-

tive evaluation of visual performance with soft contact lenses than that

already provided through conventional clinical procedures.22 This is par-

ticularly true when compared to visual performance as currently determined

through use of high contrast high spatial frequency standard acuity meas-

urements.

Early studies demonstrated a positive correlation between soft contact

lens wear and decreased contrast sensitivity function.22,2 5 These studies

emphasize that decreases in CSF, although minimal for high spatial frequen-

cies, are most evident for the intermediate spatial frequency range of 2 to

4 cycles/degree. Differences between the two functions (spectacle lens

versus contact lens) are demonstrated to be consistently greater for wear-

ers of soft lenses when compared to those of hard lenses.22 The resultant

poorer vision with contact lenses is also demonstrated as neither measur-

able through use of conventional assessment methods nor correctable through

6

refractive means. These results seem to confirm the impressions of some

contact lens wearers that they do not see as clearly with their contact

lenses as they do with their spectacles.

These studies have, however, been criticized for 1) failing to take

residuaL astigmatism into account (uncorrected asLignaLism can decrease

contrast sensitivity), 2) failing to use inferential tests to evaluate the

statistical significance of differences between type of correction (glasses

versus contact lenses), and 3) generalizing from small numbers of23

subjects.

Through studies into the moderately prolonged wear of soft contact

lenses, others have found little evidence in support of visual degradation

induced by soft contact lenses.23 However, in a recent study by Mitra and

Lamberts, contrast sensitivity for all twelve subjects tested was less with

soft lenses than with spectacles and when retested after two weeks of soft

lens wear, the CSF had decreased even more.24 Statistical analysis of

their data demonstrated a significant difference in contrast sensitivity

when wearing soft lenses as opposed to spectacles. A significant drop in

contrast sensitivity was also demonstrated by this study for subjects with

no residual astigmatism while wearing soft lenses.

In summary, existing literature strongly suggests that the wearing of

soft contact lenses does, in fact, result in a decrease in CSF for some but

not all patients. However, to date, the writer has found no published work

successful in explaining the etiology of this induced effect.

X

7

* STATEMENT OF THE PROBLEM

The proposed study is concerned not only with the correlation between

possible changes in contrast sensitivity and soft contact lens wear, but

* also with the particular aspect of the optical system (contact lens or

cornea) responsible for this effect. The question is: "Does contrast

sensitivity tell us more about a soft contact lens wearer's vision than

Snel len acuity?"

The hypotheses are two in number; first, that contrast sensitivity for

a group of patients recently fit with soft contact lenses will not be

reduced, when compared to prefit CSF with spectacles. Second, if the first

null hypothesis is rejected, that for soft lens patients showing a signifi-

cant decrease in contrast sensitivity, responsibility for this decrease can

be ascribed to either the cornea, or the contact lens, or to the cornea and

contact lens in combination. For these patients immediate contact lens

removal should demonstrate one of three different situations: (1) no

significant change in the observed contrast sensitivity, indicating changes

in the cornea as chiefly responsible for the decrease in CSF; (2) an

increase in contrast sensitivity to a level not significantly different

i |from that measured with spectacles before fitting the contact lenses,

isolating the soft contact lens as primarily responsible for the change in

CSF; (3) an increase in contrast sensitivity approaching but still signifi-

* cantly lower than prefit levels as measured with glasses, indicating a

shared relationship by both contact lens and cornea for a decreased CSF.

The first (null) hypothesis will be rejected if there is a significant

* decrease in contrast sensitivity for any of the spatial frequencies tested

8

when contact lenses are worn. It will be accepted if a significant de-

crease does not occur.

Rejection of the first (null) hypothesis will lead to consideration of

the second three step hypothesis. Step I of the second hypothesis will be

accepted if no significant change in contrast sensitivity occurs once the

contact lenses are removed; it will be rejected, however, if a significant

* change does occur. Rejection of Step I would lead to consideration of

Steps II and III of this hypothesis. Step TI of the second hypothesis will

be accepted if the change in contrast sensitivity is not significantly

different from that measured with spectacles before fitting the contact

lenses. Its rejection would logically lead to the acceptance of Step III

of this hypothesis.

9b

9

SUBJECTS

Nineteen subjects (38 eyes) were utilized for this study. The sub-

jects were selected among optometry students, and clinic patients of

Pacific University College of Optometry. All subjects were potential

wearers of contact lenses and were examined, fit, and fol lowed by senior

interns at the College of Optometry at Pacific University.

The experimental group was selected according to the following cri-

teria: (1) visual acuity correctable to 20/20 or better with best spectacle

correction (this correction was utilized for all pre- and post-contact lens

wear testing), (2) age ranging from 15 to 35 years (this range was chosen

to avoid such problems as poor comprehension of test procedures, age re-

lated effects on CSF,2'7'18 and presbyopia), (3) refractive error limited

to the spherical range of +3.00 to -6.00 diopters inclusively (this range

was chosen to eliminate the effects of high refractive error upon CSF,8'9

(4) Snellen acuity of 20/20 or better with contact lenses,* (5) no active

or inactive pathology (systemic or ocular), (6) clear media in both eyes,

and (7) pupils greater than 3 mm in diameter. 5 Details of the patient

population, including their age, refraction, soft lens prescription, and

acuities are presented in Table 1 (pages 10-13).

Normally this precludes residual astigmatism from exceeding 0.75

diopters. Measured amounts of residual astigmatism and/or sphere werecorrected during testing using a trial frame and lenses.

S•S

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14

MATERIALS AND METHODS

The instrument used in this study was the Nicolet Optronics CS-2000

(onLr'ast Sonsit ivity ' Pest in., syst,i. 'l. 11,h, CS,-2(00() i:; ;I nw in.t 11 11111i l

recently introduced to the health care field. It's appearance is onc of aI

desk top microcomputer consisting of a console (keyboard display and print-

er), a large display screen (size of a small portable TV), and an observer

response box (Figure 1). It also has a built-in calibration system which9

limits the need for external photometric calibration. This feature ensures

standard testing conditions between patients. However, since the sensi- -tivity values provided by the CS-2000 are arbitrary, the instrument was

photometrically calibrated prior to testing. This enables comparison of

data from this instrument with that of other instruments.

The CS-2000 can be programmed to electronically generate stationary,

flickering, or drifting sine wave grating targets at various levels of

contrast, spatial frequency, and mean luminance (Figure 2). The gratings

appear on the display monitor at a specific mean luminance. Through a

preprogrammed memory this instrument also provides four possible psycho-

physical techniques for test administration. The observer response box

allows the subject to signal when a pattern is first detected. This is

accomplished either by pressing a button or by adjusting grating contrast

until it is just visible. This allows measurement of relationships between

contrast sensitivity and spatial frequency for gratings which have a sin-B

usoidal luminance profile. Monocular testing of both eyes requires approx-

imately 20 minutes.

Ii I Ih CS--()0() (on tr is t S'-i t- iv lest l m, s t m

rorn left, Lo right: obser ver rtvsponsc bON, centrot cosh £011) isttkeyb~oard , and cont rast soens it iv itv y 1 plav monitor.

Sino Wave Gritinq',

0

D D D

LOW MEDIUM HIGHSPATIAL FREQUENCY

17

At a testing distance of 3 meters the display monitor, measuring 22.5

centimeters horizontally and 28.5 centimeters vertically, subtends a visual

angle of 4.3 deg horizontally by 5.4 deg vertically at the eye of the

observer. With proper adjustment of the display monitor some shimmer of

the raster lines was noted by subjects at close viewing distances, e.g.

approximately one meter. From the standard viewing distance (3 meters),

the display appeared as a bright, homogeneous field.

Uniformity of peripheral and central fields was provided by a mask

surrounding the display monitor (Figure 3). Due to subject complaints

during pre-trial studies regarding large brightness differences between

monitor and surround in a non-il luminated room some modifications were

necessary. A 40 watt incandescent bulb was located above the monitor and

behind the mask to provide a low level of indirect background illumination.

Its location behind the mask avoided complications, e.g. screen reflection,

which might have resulted from use of an alternate location.

The CS-2000 may be calibrated using any one of three methods: (1)

Standard Method - This semi-automatic method of calibration is designed to

keep the instrument seL for proper contrast and luminance values over time.

Proper use of this method assures that the display monitor when measured at

screen center is set for 100 candela per square meter average luminance,

and 0.50 peak contrast. (2) Photometric Method - This method allows the

operator to adjust the display to a specified mean luminance and contrast,

and to verify that the display behaves in a linear fashion at these set-

tings. (3) Non-Standard Method - This third method allows the CS-2000 to

11scan" the display monitor after it has been calibrated to some non-stan-

dard luminance and contrast. The display monitor may then be set to those

H

A

F

I

19

same values using the "standard method" calibration routine.

After final establishment of the testing environment, i.e. instrument

modifications, lighting, patient position, etc., the "standard method" was

S used to calibrate the CS-2000. Following this a Tektronix J-16 Photometer

with J6523 luminance probe (I deg measuring circle) was used in combination

with the "photometric method" of calibration to verify the lumiuiance and

contrast settings established by the "standard method". Peak contrast was

measured at0.54 6, a 6.2% difference from the expected value 0.50 (see

Appendix A for details). Error analysis for calibration drift based on

interval variance within the +5% limit was also determined (Appendix B).

This information was used at the end of each data collection period to

assure that instrument calibration had remained within a predetermined

tolerance range of +5% during testing for a given period of time.

With calibration complete, the average luminance, based on 13 measure-

ments, for the featureless screen was measured at 93 candela/meter2 (see

Appendix C for details). Eight measurements were used to evaluate the

screen border. The average luminance was found to be 1.59 candela/meter2;

maximum deviation from mean luminance was 38.4% (see Appendix D). This

deviation was explained by screen reflection from the table surface upon

which both the display monitor and surround were resting (Figure 3). Last-

ly, the ambient illuminance at the subject's entrance pupil (3 meters from

screen) for all testing was measured using a Tektronix J-16 Photometer with

J6511 illuminance probe at 4.7 lux (lumens/meter 2 ).

Through design, programming of the CS-2000 for testing has been facil-

itated by grouping all non-standard test options into three general cate-

gories. These are as follows: (1) Setup - the selection and configuration

It

20

of apparatus, i.e. test distance, screen size, line rate, and peak con-

trast, (2) Method - the psychophysical technique employed, i.e. Von Bekesy

tracking method, visual evoked response mode, method of adjustment, and

* method of increasing contrasts, and (3) Stimuli - the pattern presented

during testing, i.e. number, type (static, moving, counterphase, full-field

flicker, and intermixed), grating vs. bar, and contrast. The final format

determined for this study is described below (Apppendix E).

The standard "Set-Up" option was used for all testing. This allowed

for a viewing distance of three meters which is strongly recommended by the

manufacturer for the following reasons: (1) large display angular sub-

tense, (2) ease of viewing even for observers who have difficulty accomo-

dating, and (3) elimination of the problems that may accompany close view-

ing of any modulated-raster display. This option assumes that the CS-2000

display monitor alone will be used at a pre-programmed peak contrast of

0.5. Contrast values above 0.6 will influence monitor linearity and must

be compensated for.

The psychophysical "Method" chosen for this study was that of in-

creasing contrasts (ascending limits), i.e. the contrast of the light and

dark bars is raised until the subject is just able to detect the grating.3 2

A preview of each stimulus pattern was also provided. Total preview time

(including two-second plateau time plus the minimum time needed for on-and

off-ramps) was four seconds. The standard preview contrast of 0.5 was

decreased to 0.2. This reduction was essential to the elimination of pre-

view afterimages which might interfere with subjects' responses. Full

* scale time or the time the CS-2000 will take to change pattern contrast

from zero to full contrast was an important consideration. When full scale

21

* time is low, contrast changes quickly and observer reaction time becomes

more significant. This will interfere with proper interpretation of the

data. At the other extreme high values result in observer impatience which

* might lead to unreliable responses. After careful consideration of all

project parameters, including subject criteria, the manufacturer's rocom-

mended value of 30 seconds was decided upon. The instrument was programmed

to repeat the test grating four times in succession to obtain an average

contrast threshold for each spatial frequency.

The "Stimuli" format consisted of eight separate trials, each of which

presented a single static sinusoidal grating. The first two trials, which

presented gratings of 1.0 and 6.0 cycles/degree, were used to provide

practice for the observer. The remaining six, representing 0.5, 1.0, 3.0,

6.0, 11.4, and 22.8 cycle/degree gratings presented in random order, were

data-collection trials (Figure 4). The top of the range from which the

starting contrast was to be randomly selected was specified as 0.001.

Initial pattern presentation would therefore occur at some randomly chosen

point between 0 and 0.001. A trial repeat would automatically re-randomize

the starting contrast. Through use of standard instrument provisions,

trials were aborted and/or repeated and new stimuli added at the option of

the operator.

Prior to the experimental procedure instrument reliability testing was

* performed for the CS-2000 (see Appendix F for detai ls). Nine randomly

chosen subjects (18 eyes) were chosen for the study; repeat testing did not

occur sooner than two days or longer than five days following the initial

* test. Pearson's Product Moment Correlation Coefficients (r) were deter-

mined for each of the six spatial frequencies to be used in the primary

0.5 Cycles/Degree 1.0 Cycles,'Degree 3.0 Cycles/Degree

I.l

23

P study. The spatial frequency of 0.5 cycles per degree was found to have

the lowest correlation value (r=.777), while 3.0 cycles/degree was found to

have the highest (r=.949). All "r" values were statistically significant

at the 0.001 level.

On the day of the actual experimental procedure, but prior to con-

ducting the trial, aided visual acuity was measured for each subj.,ct using

Snellen letters. Pupillary diameters were also recorded. The subject was

then seated at the fixed distance of three meters from the CS-2000 display

monitor; this distance remained constant for all subsequent testing.

Prior to contact lens fitting, contrast sensitivity for the six pre-

selected spatial frequencies, ranging from 0.5 cycles per degree to 22.8

cycles per degree, was determined monocularly for each patient while

glasses were worn (Baseline Data). Immediately following fitting, this

testing was repeated, not occurring however, sooner than 30 minutes or

longer than 60 minutes following the fitting of the soft lens (Dispensing

0 Data). Measured amounts of residual astigmatism and/or sphere were cor-

rected during testing using a trial frame and lenses. Once completed, the

contact lenses were removed and testing redone for each eye. Similarly,

before and after testing was done at both one and four weeks following the

initial fitting. On these occasions and immediately prior to testing, all

t. subjects were to have worn their contact lenses continuously for no less

i Dthan four hours and no more than eight.

Ii' II I I I I I l . .L I I I i . . .. . " i in '.. . .. . , i

24

* TREATMENT OF DATA

The aim of the first portion of this study was to determine whether or

not the wear of soft contact lenses would significantly reduce any portion

* of the prefit contrast sensitivity function for the 38 eyes (19 subjects)

tested. Six unidirectional "t" tests (for related measures), one for each

spatial frequency, were used to compare prefit contrast sensitivity data

(baseline) with that when contact lenses were worn and residual error was

corrected (collected at dispensing, one week following dispensing, and one

month following dispensing). Results are considered significant if there

is less than one percent probability of obtaining a calculated "t" value by

random factors alone (P<O.O1). 3 4 However, if the probability is between

one and five percent (0.0<P<O.05) the results are considered probably

significant.35 Sig~iificance, in this context, means that contrast sensi-

tivity is changed (lowered) with contact Lenses when compared to That with

spectacles; e.g., when the level of significance is 0.01, there is only a

one percent chance of obtaining the observed decrease in contrast sensi-

tivity by random factors alone.

If a decrease for any spatial frequency was found to be statistical l y

significant, those subjects demonstrating a clinically significant decrease

in contrast sensitivity for that frequency (one standard deviation from the

mean contrast sensitivity with spectacles) were further evaluated. A

unidirectional "t" test for related measures was used to determine respon-

sibility for this loss. Contrast sensitivity data with the contact lens on

was compared to that just after the contact lens was removed. A signifi-

*cant (as defined in the previous paragraph) increase in contrast sensi-

tivity would not only reject Step I of the second hypothesis, i.e. the

* I

25

cornea being chiefly responsible for the decrease in contrast sensitivity,

but would require further consideration of Steps II and III. If the re-

sults of this comparison were not significant Step I was accepted and

consideration of the remaining steps was unnecessary.

Assuming rejection of Step I, a unidirectional "t" test (post contact

lens wear-prefit) would then be necessary. If the difference here is not

significant, Step II of the hypothesis, i.e. the contact lens being chiefly

responsible for the decrease in contrast sensitivity, is accepted. A

significant difference however, would logically lead to a rejection of Step

II and subsequent acceptance of Step III. This would then indicate a

shared relationship by both the contact lens and cornea for a decreased

contrast sensitivity.

Since each spatial frequency was tested for change at three different

times, part of the data analysis probed the effects of successive experi-

mental manipulations (dispensing, one week, one month). The statistical

procedure used for this purpose was adapted from a "Treatment by Subjects"

(repeated measures) design. 3 3 This design is also known as a "Single

Factor Analysis of Variance" (code name SANVAR), on file at the Pacific

University College of Optometry Computer Center (see Appendix G). The

experimental group was evaluated by SANVAR using the three contrast sensi-

tivity values, one for each point in time, as the repeated measures for

each subject.

The SANVAR calculation produces a F ratio which is used to estimate

the probability of random occurrence of the experimental results. Results

are considered significant if there is less than one percent probabi lity of

obtaining a calculated F by random factors alone (P<O.O1).34 However, if

$

26

* the probability is between one and five percent (O.O1<P<O.05) the results

are considered probably significant.3 5 Significance, in the present con-

text, means nonrandom variation (instability between treatments) in con-

trast sensitivity measures over time.

,j

I

S1

27

RESULTS

Relative to the first hypothesis data analysis performed with the "t"

test (Appendix H) is demonstrated in Table I. The value "t" for al I but

the highest (22.8 cycles/degree) and lowest (0.5 cycles/degree) spatial

frequencies tested was found to be statistically insignificant. The

"baseline-dispensing" "t" value (t=-1.807) for 0.5 cycles/degree is signif-

icant between the 0.05 and 0.025 level. This indicates a probably signifi-

cant increase in contrast sensitivity for those newly fit contact lens

wearers at a spatial frequency of 0.5 C/D. The probability of the cal-

culated "t" value occurring by chance is between five and two and one-half

times in one hundred.

The "baseline-dispensing" "t" value (t = 2.349) for 22.8 cycles/

degree, the highest spatial frequency tested, is significant between the

0.025 and the 0.01 level. This indicates that the probability of the

calculated "t" value occurring by chance is between two and one-half and

one times in one hundred. The remaining "t" values for this same fre-

quency, "baseline-one week" (t = 3.390) and "baseline-one month" (t =

3.905) are statistically significant below the 0.005 level. This indicates

the probability of these "t" values occurring by chance is less than five

times in a thousand and five times in ten thousand respectively. It is

thus concluded that measured contrast sensitivity with contact lenses

(residual error corrected) is significantly lower when compared to that

measured with spectacles for only the highest (22.8 cycles/degree) of the

spatial frequencies measured. This decrease is graphically demonstrated

using the mean contrast sensitivity values in Table III (See Figure 5).

I

28

Table T1: Significance study (unidirectional "t" test for relatedmeasures*) comparing contrast sensitivity data. Data takenwith contact lenses (residual error corrected) at dispens-ing, one week, and one month are compared to that taken withspectacles before contact lens fitting (baseline data).

SPATIALFREQUENCY DISPENSING ONE WEEK ONE MONTH

"t" value -1.807 -.927 -.918

0.5 C/D Significance Probably Not NotTest** Significant Significant Significant

P <.05 P <.25 P <.25

"t" value -.155 -.296 -.344

1.0 C/D Significance Not Not NotTest*" Significant Significant Significant

P <.25 P <.25 P < .25

"t" value -.888 -.861 -.693

3.0 C/D Significance Not Not NotTest** Significant Significant Significant

P <.25 P <.25 P <.25

"t" value .316 .018 -.117

6.0 C/D Significance Not Not NotTest** Significant Significant Significant

P <.25 P <.25 P< .25

"t" value .152 -.697 .044

11.4 C/D Significance Not Not NotTest* Significant Significant Significant

P <.25 P <.25 P< .25

"t" value 2.349 3.390 3.905

22.8 C/D Significance Probably Highly HighlyTest** Significant Significant Significant

P <.025 P < .005 P < .0005

See Appendix HN = 38 eyes (19 subjects) I :

29

Table IIt: Mean contrast sensitivity* (+I standard deviation) withspectacle or soft contact lens correction.

SPATIAL CONTRAST SENSITIVITYFREQUENCYIN CYCLES SPECTACLES SOFT CONTACT LENS**

PER DEGREE

BASELINE DISPENSING ONE WEEK ONE MONTH

0.5 25.5+ 12.1 29.4 + 17.8 27.0 + 13.2 27.3 + 15.6

1.0 59.4 20.8 59.8 + 22.4 60.4 + 23.1 58.3 ± 23.6

3.0 122.5±35.5 127.5+34.5 126.7+29 126.3±34.1

6.0 111.7±37.5 109.8+34.8 111.6+32.6 112.4±35

11.4 61.3+23.7 60.7+24.8 64.0+24.1 61.1 +22

22.8 27.9 + 12.4 24.1 + 12.3 22.6 + 10.1 21.8 + 9.7

N = 38 eyes (19 subjects)** Residual error corrected

30

*-@ Baseline (spectacles)o.... o One Month (contact lens with residual

5004 error corrected)

_2004

_ 1504

C4

~50,

.b

0.5 1.0 3.0 6.0 11.4 22.8

SPATIAL FREQUENCY (CYCLE/DEGREE)

Figure 5. Graph of Contrast Sensitivity Function (CSF). Mean contrastsensitivity is plotted as a function of cycles/degree. This isreferred to as contrast sensitivity function (CSF). Grer", above

* compares baseline CSF (measured with spectacles) to that meazuL.J afterone month of soft contact lens wear (measured with residual errorcorrected). Data taken from Table III, page 29.

1..

31

For those eyes demonstrating a clinically significant decrease in

contrast sensitivity (one standard deviation from the mean contrast sensi-

tivity with spectacles) further comparisons are made (see Table IV). Data

taken with the contact lenses are compared to that taken immediately fol-

lowing contact lens removal. Comparisons are made for data collected at Id,1

dispensing, one week, and one month. All "t" values are statistically

significant at the 0.005 level, indicating the probability of these "t"

values occurring by chance is less than five times in a thousand. It is

thus concluded that measured contrast sensitivity immediately following

contact lens removal is significantly higher than that measured with the

contact lens (residual error corrected). This not only rejects Step I of

the second hypothesis but also requires consideration of Steps II and III.

Data taken immediately following contact lens removal is compared to

that taken with spectacles before contact lens fitting (baseline) (see

Table V). All "t" values show significance with that at one month demon-

strating the highest significance (P<0.01). It is thus concluded that

although significantly elevated following contact lens removal, contrast

sensitivity values for these eyes are statistically different (lower) than

prefit baseline data.

Supplemental SANVAR analysis of the data for each spatial frequency

yielded the following:

0.5 C/D F = 1.09

1.0 C/D F = 0.40

3.0 C/D F = 0.04

* 6.0 C/D F = 0.16

I

r32

11.4 C/D F = 0.69

22.8 C/D F = 1.53

All F values would occur more often than 20 percent of the time through

random factors alone (P>0.20).* It is, thus, concluded that the measured

contrast sensitivity values were stable over the range of testing sessions

used in this study.

Critical F ratio for dfl/df 2 of 2/74 is 1.65 at the twenty percent

level of significance.

-

33

Table IV: Significance study (unidirectional "t" test for relatedmeasures) comparing contrast sensitivity data for eyesdemonstrating a clinically significant decrease in contrastsensitivity. Data taken with contact lenses (residual errorcorrected) at dispensing, one week, and one month arecompared to that taken immediately following contact lensremoval.


"t" value 3.981 3.599 619

22.8 C/D Highly Highly HighlySignificance Significant* Significant* Significant*

Test P <.005 P <.005 P <.005

N = 16 eyesN = 19 eyesN = 19 eyes

r

• V

34

Table V: Significance study (unidirectional "t" test for relatedmeasures) comparing cont r~ist sensit i vty data for eyesdemonstrating a cl inicallIy significant decrease in contrastsensitivity. Data taken immediatel y fol l owing contact lensremoval at dispensing, one week, and one month are comparedto that taken with spectacles before contact lens fittingA1(baseline data).


"t" value 2.358 2.238 2.602

22.8 CID Probably Probably ProbablySignif icance Significant* Significant"* Significant'

Test P <,025 P K .025 P <.01

N N= 16 eyesN =l9 eyesN = N 19 eyes

35

DISCUSSION AND CONCLUSION

The objective of this study was to investigate the correlation between

changes in contrast sensitivity before and after soft contact lens wear.

The overall question was: "Does contrast sensitivity tell us more about a

soft contact Iens wearer's v is ion than Sne I I en acu it V?"

The research questions were as follows: (1) Is contrast sensitivity

for a group of patients recently fit with soft contact lenses reduced, when

compared to prefit CSF with spectacles? (2) If, in fact, a significant

decrease in contrast sensitivity occurs, can this be ascribed to (a) the

cornea alone, (b) the contact lens alone, or (c) the cornea and contact

lens in combination?

To examine these questions, measurements of contrast sensitivity for

six spatial frequencies ranging from 0.5 to 22.8 cycles/degree were taken

before and after the wearing of the contact lenses. Measurements occurred

iit dispensing and subsequent to dispensing at intervals of one week and one

month.

Based on the results of the "t" test (related measures) measured

contrast sensitivity with contact lenses is significantly lower for only

the highest of the six spatial frequencies measured (22.8 cycles/degree)

when compared to that measured with spectacles. This decrease, ranging

between 14 and 22 percent, was consistent for each testing session. Levels

of significance ranged from 0.025 to 0.0005 depending on the time of lens

wear measured from day of dispensing. It is noted, however, that most

subjects experienced problems while responding to both the lowest (0.5

*cycles/degree) and the highest (22.8 cycles/degree) spatial frequencies at

the time of lens dispensing. The probably significant increase in contrast

36

sensitivity for 0.5 cycles/degree measured at dispensing was not repeatable

at subsequent test sessions and was probably due to poor lens adaptation.

Thus, the first null hypothesis (H.) is rejected.

For those eyes demonstrating a clinically significant decrease in A

contrast sensitivity for 22.8 cycles/degree further examination revealed:

(1) sequential rejection of Steps I and IT of the second null hypothesis

(H0 ), and (2) acceptance of Step III. The implication from this result is

two fold: (1) decreased contrast sensitivity with contact lenses is ele-

vated once again when the lenses are removed, and (2) after lens removal

these elevated contrast sensitivity values fall short of prefit measure-

ments within the time interval tested. Therefore, it is concluded that the

etiology for decreased contrast sensitivity resulting from contact lens

wear is shared by both the contact lens and the cornea. Step III of the

second null hypothesis is therefore accepted.

Based on the results of the SANVAR analysis, it is also concluded that

there is no significant variation of the measured contrast sensitivity

values over the range of testing sessions used in this study. In other

words, decreased contrast sensitivity during the wear of soft contact

lenses did not fluctuate (increase or decrease) over the tine evaluated.

In view of the literature and the results of this study, two facts

were apparent. First, there is reason to question the literature which

demonstrated large losses in contrast sensitivity with softcontact lens

wear for the low and middle spatial frequency range. Second, when compar-

ing the results of this study with the pre- and post- visual acuities found

in Table I (pages 10-13) it is difficult to demonstrate quantitatively

that contrast sensitivity does in fact tel I us more about a soft contact

$

37

II

lens wearer's vision than Snellen acuity. The fact that approximately one-

half of the eyes used in this study showed a small, but measurable, loss in

Snellen acuity with contact lens wear correlates well with contrast sensi-

tivity losses for high spatial frequencies.

The conclusions of this study are as follows:

(1) CSF is lowered with soft contact lenses for only the highestspatial frequency tested (22.8 cycles/degree).

(2) Etiology for this decrease is shared by both the contact lens andthe cornea.

(3) Measurement of CSF as a diagnostic tool in the fitting of softcontact lenses is not warranted. When compared to Snellenacuity, sufficient additional information is not provided.

.

S'

38

References

1. Arden, G.B. The importance of measuring contrast sensitivity in casesof visual disturbance. British Journal of Ophthalmology, 1978,62, 198-209.

2. Arundale, K. An investigation into the variation of human contrastsensitivity with age and ocular pathology. British Journal ofOphthalmology, 1978, 62, 213-215.

3. Bodis-Wollner, I. Detection of visual defects using the contrastsensitivity function. In Electrophysiology and Psychophysics:Their Use in Ophthalmic Diagnosis, S. Skol (Ed), Boston, Little,Brown and Company, 1980, 135-153.

4. Bodis-Wollner, I. and Diamond, S.P. The measurement of spatialcontrast sensitivity in cases of blurred vision associated withcerebral lesions. Brain, 1976, 99, 695-710.

5. Cambell, F.W. and Green, D.G. Optical and retinal factors affectingvisual resolution. Journal of Physiology, 1965, 181, 576-593.

6. Comerford, J.P. Contrast sensitivity for clinical optometry. Journalof the American Optometric Association, 1979, 50(6), 683-686.

7. Derefeldt, G., Lennerstrand, G., and Lundh, B. Age variations innormal human contrast sensitivity. ACTA Ophthalmologica, 1979,57, 679-690.

8. Enoch, J.M., Ohzu, H., and Itoi, M. Contrast (modulation) sensitivityfunctions measured in patients with high refractive error withemphasis on aphakia: I. Theoretical considerations and II. De-terminations on patients. Documenta Ophthalmologica, 1979,47(1), 139-162.

9. Fiorentini, A. and Maffei, L. Spatial contrast sensitivity of myopicsubjects. Vision Research, 1976, 16(4), 437-443.

10. Ginsburg, A.P. and Evans, D.W. Contrast sensitivity predicts pilot'sperformance in aircraft simulators. American Journal ofOptometry and Physiological Optics, 1982, 59(1), 105-109.

1i. Hess, R.F. and Carney, L.G. Vision through an abnormal cornea: Apilot study of the relationship between vision loss from cornealdistortion, corneal edema, keratoconus, and some allied corneal-pathology. Investigative Opthalmology and Visual Science, 1979,18, 4 76-483.

* 12. Hess, R. and Garner, L. The effect of corneal edema on visualfunction. Investigative Ophthalmology and Visual Science, 1977,16(1), 5-13.

39

13. Hess, R.F. and Howel l, F.R. The threshold contrast sensitivityfunction in strabismic amblyopia: evidence for a two typeclassification. Vision Research, 1956, 17, 1049-1056.

14. Hess, R. and Woo, G. Vision through cataracts. InvestigativeOphthalmology and Visual Sciences, 1978, 17, 428-36.

15. Kleinstein, R.N. Contrast sensitivity. Optometric Monthly, 1981,72(4), 38-40.

16. Pitman, R. and Yolton, R. Introduction to special tests forassessment of vision in elderly patients. In Vision and Aging:General and Clinical Perspectives, M. Morgan and A. Rosenbloom(Eds), Chicago, The Professional Press, Inc., In Press.

17. Regan, D., Silver, R., and Murray, T.J. Visual acuity and contrastsensitivity in multiple sclerosis: Hidden visual loss. Brain,1977, 100, 563-579.

18. Sekuler, R. and Hutman, L.P. Spatial vision and aging: I. Contrastsensitivity. Journal of Gerontology, 1980, 35(5), 692-699.

19. Sjostrand, J. and Frisen, L. Contrast sensitivity in macular disease.ACTA Ophthalmologica, 1977, 55, 507-514.

20. Skalka, H.W. Comparison of Snellen acuity, VER acuity, and Ardengrating scores in macular and optic nerve diseases. BritishJournal of Ophthalmology, 1980, 64, 24-29.

21. Zimmern, R.L., Cambell, F.W., and Wilkinson, I. Subtle disturbancesof vision after optic neuritis elicited by studying contrastsensitivity. Journal of Neurology, Neurosurgery and Psychiatry,1979, 42, 407-412.

22. Applegate, R.A. and Massof, R.W. Changes in the contrast sensitivity

function induced by contact lens wear. American Journal ofOptometry and Physiological Optics, 1975, 52, 840-846.

23. Bernstein, J.H. and Brodrick, J. Contrast sensitivities throughspectacles and soft contact lenses. American Journal ofOptometry and Physiological Optics, 1981, 58(4), 309-313.

24. Mitra, S. and Lamberts, D.W. Contrast sensitivity in soft lenswearers. Contact and Intraocular Lens Medical Journal, 1981,7(4), 315-322.

25. Woo, G. and Hess, R. Contrast sensitivity function and soft contactlenses. International Contact Lens Clinic, 1979, 6, 37-42.

26. Wechsler, S. Visual acuity in hard and soft contact lens wearers: A

comparison. Journal of the American Optometric Association,1978, 49(3), 251-256.

I |40

27. Westheimer, G. Aberrations of contact lenses. American Journal ofOptometry and Archives of the American Academy of Optometry,1961, 38(8), 445-448.

28. Bauer, G.T. Longitudinal spherical aberration of modern ophthalmiclenses and its effect on visual acuity. Applied Optics, 1980,19(13), 2226-2234.

29. Millodot, M. Variation of visual acuity with contact lenses. Archivesof Ophthalmology, 1969, 82, 461-465.

30. Nicolet CS-2000 Contrast Sensitivity Testing System Operation Manual.Madison, Wisconsin, Nicolet Biomedical Instrument Corporation,1982, 1-30.

31. Ginsburg, A.P. Contrast sensitivity: Relating visual capability toperformance. USAF Medical Service Digest, 1983, AFRP 160-1,34(4), 15-19.

32. Kelly, D.H. Visual contrast sensitivity. Option Acta, 1977, 24(2),107-129.

33. Bruning, J.L. and Kintz, B.L. Computational Handbook of Statistics.Glenview, Illinois, Scott Foresman and Co., 1968, 152-155.

34. Fisher, R.A. Statistical Methods for Research Workers, 13th Edition.New York, Hafner Publishing Co., 1967, 209.

35. Spiegle, M.R. Probability and Statistics. New York, McGraw-Hil l,1975, 232.

Sh

*I

41

APPENDIX A

PHOTOMETRIC MEASUREMENT OF MONITOR DISPLAY (PEAK CONTRAST)

-7

S

41A

I. Photometric measurement of monitor display (peak contrast).

A. A Tektronix J-16 Photometer with J6523 luminance probe was usedt measure the peak contrast of the monitor display. As de-scribed in the Nicolet CS-2000 Contrast Sensitivity Testing Sys-tem Operation Manual, the "standard method" of calibration wasused to set the display monitor for 100 candela per square meteraverage luminance, and 0.50 peak contrast (both measured atscreen center). 3 0 All readings were taken under the samelighting conditions as used for testing.

B. Using the "photometric method" of calibration, two measurements 4were taken. Both readings were taken at the center of the screenusing a 1 deg measuring circle. As demonstrated below, onemeasurement was for a predesignated "bright" bar which was pro-grammed to appear in the center of the display monitor, the otherfor a "dark" bar.

Units ofMeasurement = nits

150 46 (candela/meter2 )

C. Peak Contrast = _ax - lin _ 150 -46 - 0.531Luax + Lmin 150 + 46

D. % Deviation from expected = 0.531 - 0.500 X 100 ; 6.2%0.500

'I

U

42

lLI

APPENDIX B

4"CALIBRATION DRIFT" ERROR ANALYSIS

42A

I. "Calibration drift" error analysis

A. A more detailed understanding of the "standard method" ofcalibration is required by the reader to understand the followingprocedure. Each time this mode of calibration is used theinstrument will internally monitor its own luminance for a fewseconds. This completed, a message will appear indicating: (1)the display control (brightness or contrast) that is further fromproper adjustment, (2) a sign, (+) or (-), indicating thedirection in which to adjust the specified control, and (3) a

reading of BRIGHTNESS (+6) indicates that: (1) the brightness

control is further from proper adjustment, (2) this control mustbe adjusted in a clockwise direction (minus represents acounterclockwise direction), and (3) the degree of maladjustmentis relatively low.

B. A Tektronix J-16 Photometer with J6523 luminance probe was usedto measure the luminance of the monitor display. As described inthe Nicolet CS-2000 Contrast Sensitivity Testing System OperationManual, the "standard method" of calibration was used to set thedisplay monitor for 10 candela per square meter average lumi-

nance, and 0.50 peak contrast (both measured at screen center).All readings were taken under the same lighting conditions asused for testing. All readings were taken at the center of thescreen using a 1 deg measuring circle.

C. A four step method used to analyze drift error.

(1) Calibrate the display monitor using the "standard method".

(2) Generate one "light" or one "dark" bar of light on themonitor using the "photometric method" of calibration (seeAppendix A). Measure its luminance.

(3) While photometrically monitoring the luminance of the barused in Step 2, adjust the luminance of the bar up or downby 5 percent. This is accomplished using either thebrightness or contrast control.

(4) Repeat calibration using the standard method. The initialreadout will indicate the required adjustment for theinstrument which has drifted 5 percent from calibration.

* Continue steps (1) through (4) until (+) and (-) values aredetermined for both display controls (brightness andcontrast).

I

II

42B

D. Data collection using the four step method described in C.

Trial 1: (1) Calibrate(2) Light bar = 150 candela/meter 2 2

(3) Adjust "light bar" upward 5% to 158 candela/meterusing brightness control.

(4) Required adjustment = BRIGHTNESS (-3)

Trial 2: (1) Calibrate(2) Light bar = 150 candela/meter2 2(3) Adjust "light bar" upward 5% to 158 candela/meter

using contrast control.(4) Required adjustment = CONTRAST (-10)

Trial 3: (1) Calibrate(2) Light bar = 150 candela/meter2

(3) Adjust "light bar" downward 5% to 142candela/meter2 using brightness control.

(4) Required adjustment = CONTRAST (+8)

Trial 4: (1) Calibrate(2) Light bar = 150 candela/meter

2

(3) Adjust "light bar" downward 5% to 142candela/meter2 using brightness control.

(4) Required adjustment = BRIGHTNESS (+7)

NOTE: Although luminance adjustment for Trial 3(3) was identical to that of Trial 4 (3) above,required adjustments in part 4 of each trial were

different. As mentioned earlier in this appendix(section A) the CS-2000 is internally programmedto indicate which display control, brightness orcontrast, is further from proper adjustment. De-spite adjustment of only one control,however, bothmeasures are affected. The operator was unable topredictably control this characteristic. It ap-pears to be inherent to the internal programmingof this instrument.

E. Error analysis based on interval variation within the +5% limitreveals a range of:

* BRIGHTNESS +7 - 3

CONTRAST +8 ( ) -10

14

APPENDIX C

PHOTOMETRIC MEASUREMENT OF MONITOR DISPLAY (AVERAGE LUMINANCE)

43A

I. Photometric measurement of monitor display (average luminance).

A. A Tektronix J-16 Photometer with J6523 luminance probe was usedto measure the luminance of the monitor display. As described inthe Nicolet CS-2000 Contrast Sensitivity Testing System OperationManual, the "standard method" of calibration was used to set thedisplay monitor for 100 candela per square meter average lum6nance, and 0.50 peak contrast (both measured at screen center).All readings were taken under the same lighting conditions asused for testing. Thirteen measurements were taken as demon-strated below. A 2.3 centimeter spot was used at a distance of1.5 meters from the screen (measuring circle of approximately 1deg). All readings were adjusted using the 'orrecting Factor"determined by photometric calibration in Part II (below).

1 88 98k /

95 98

8 x / /Units of measurement98 97 109

/ \ nits (candela/meter2 )

94 96/

/

79 80 91

Central luminance = 97 nits

Average luminance - 93 nits

B. Z deviation at high extreme (109 nits)

109 nits - 93 nits X 100 = 17.2%93 nits

% deviation at low extreme (79 nits) =

79 nits - 93 nits X 100 = 15.1%93 nits

I

"d

.!

43B

II. Calibration of photometer using a 342 nit (candela/meter 2 ) standard(Photo Research Corp., BSR-100-B).

Correcting Factor (CF) = 342 nits (expected) 1.056*324 nits (actual)

t

iH

* This factor varies somewhat from one day to the next, probably due toinherent instabilities in the photometer. Due to the characteristicsof the reference source (Photo Research Corp., BSR-100-B) short termvariations are much less likely here.

S

44

APPENDIX D

PHOTOMETRIC MEASUREMENT OF PERIPHERAL SURROUND

I

-1

44A

* I. Measurement of peripheral surround.

A. A Tektronix J-16 Photometer with J6523 luminance probe was usedto measure the luminance of the peripheral surround. Eightmeasurements were taken 2 centimeters from the screen borderusing a 1 deg measuring circle. All readings were taken underthe same lighting conditions as testing. All readings wereadjusted using the "Correcting Factor" determined by photometercalibration in Part II (below).

1.4 1.4 1.4

1.4 1.5 Average luminance = 1.59 nits

(candela/meter2 )

1.6 2.2 1.8

B. % Deviation at high extreme (2.2 nits) =

2.2 nits - 1.59 nits X 100 = 38.4%

1.59 nits

% Deviation at low extreme (1.4 nits) -

1.4 nits - 1.59 nits X I00 = 11.9%

1.59 nits

C. Maximum deviation from mean luminance = 38.4%

NOTE: Luminance elevation at lower border of surround is

due to reflection from table surface upon which the surroundand display monitor rest (Figure 2).

II. Calibration of photometer using a 342 nit (candela/meter2 ) standard(Photo Research Corp., BSR-100-B).

A. Photometer reading at start of procedure = 315 nitsPhotometer reading at finish of procedure = 320 nits

Average = 318 nits

[I,

44B

B. Correcting Factor (CF) - 342 nits (expected) = 1.075*318 nits (actual)

C. % Error (start) = 342 nits - 315 nits X 100 = 7.9%

342 nits

% Error (finish) = 342 nits - 320 nits X 100 = 6.4%

342 nits

D. Average error over time = 7.15%

* This factor varies somewhat from one day to the next, probably due to

inherent instabilities in the photometer. Due to the characteristicsof the reference source (Photo Research Corp., BSR-100-B) short termvariations are much less likely here.

45

APPENDIX E

CS-2000 PROGRAM FORMAT

45A

CS-2000 Program Format:

Effects of Soft Contact Lenses on Contrast Sensitivity

MESSAGE RESPONSE

Stiadard Set -lip..........................au I

Standard Method. ............... ..... N

Method (BVAI) .. .. ................ I

# Repeats. .. .................. . . 4

Preview .. .............. ....... Default .Preview Time. ............... .... 2.0

Preview Contrast. .................. 0.2

Full Scale Time .. ............... .. Default

Print All Data. ............... ... Default

Standard Stimuli .. ............... .... N

# Stimuli .. ............... ..... 8

S. Type (SMCFI) .. ................. S

Grating/Bar/User. ...................

Specify Contrasts .. .............. .. Y

(1) 6.0/.001**~Trial

(2) 1.0/.001

(3) 3.0/.001

(4) 0.51.001

(5) 1.0/.001Test

(6) 22.8/.001

(7) 6.0/.001

(8) 11.4/.001>

* D46

* j

APPENDIX F

INSTRUMENT RELIABILITY TESTING (TEST-RETEST)

dA,

$

46A

I. Instrument Reliability Testing (Test-Retest)t

A. Test reliability (stability) for the CS-2000 was determined bytest administration to randomly chosen subjects on two differentoccasions. Reliability was defined as the Pearson Product MomentCorrelation between the two sets of scores. Program format fortest administration was identical to that to be used in theprimary study (discussed in detail under the heading "MATERIALSAND METHODS"). Nine randomly chosen subjects (18 eyes) werechosen for this sLudy. Repeat- Lesting did not occur sooner thantwo days or longer than five days following the initial test.

B. Data (Individual data sheets are numbered (46B - 46J)

C. Program used to calculate the Pearson Correlation Coefficient(pages numbered 46K - 46M)

D. Results

Spatial Pearson ProductFrequency Moment Correlation

Coefficient*

0.5 0.77715

1.0 0.842174

3.0 0.949378

6.0 0.947023

11.4 0.948346

22.8 0.888501

* All "r" values are statistically significant at the 0.001 level.

S

T=Contrast ThresholdSD=Standard Deviation 46B

RIGHT EYE

SpatialTrial #1 Trial #2

Frequency

CS531-

.5 T - -

SD .IP ,

CS -

1.0 T

SD .1.9 Iaf

CS

3.0 T - - .

_________ SD 71_ _ _ _ _ _ _

CS

6.0 T - -

SD

CS

11.4 T -2.O --

SD OIL

cs q4 / '

22.8 T /,941- - t, s-

SD * , O_ _

LEFT EYE

CS

.5 T ;. - - , y

SD __ __ _. _ _y

CS

1.0 T -. -

SD .031 lots

CS Isry. ? 7",

3.0 T - C2,i - ,1I3

SD ,_ _ _ _ _ _/_ , _

CS W

6.0 T - .

SD ,117 ,O

$ cs /eO, ~11.4 T .- ,o;Z _ .?,

__ __ __ _ SD __ __A _ _ _ ___1_ _

CS y 361,

22.8 T - 6.Q .0 I-J

F7T=Contrast ThresholdSD=Standard Deviation 46C

RIGHT EYE


Frequency

CS /.

.5 T --/.Ot - - 1./W

SD OS-,t3

cs qo. Y]. ;L

1.0 T - .

SD .or" ,0'03

CS

3.0 T - ,o . - /,

cs .. 2 oSD .0s8.

CS6.4 T - - .37

SD ,o.082cs I .4 13.3

22.8 T - -SD 2 0

SD 00 O& . .0""Y

LEFT EYE

CS S

.5 T - ,03

SD ,1_ _ ,1o 5"

Cs s-I.3? 93.?

1.0 T - /.?/F -

SD ,of _._0?3_

CS //.'? /10.3

3.0 T -- .,o - -,,________ SD .O-I

6.0 T - 2,0( ,

____ ____ SD __ _ _ _ _ __O

CS o ,/ ,

11.4 T - /.')'- 1.2

SD %031 .0_C

CS 1(.322.8 T - .3.- /ews-

SD 037

T=Contrast ThresholdSD=Standard Deviation 46D

RIGHT EYE

Spatial ITrial #1 Trial #2

Frequency

~cs -- / j,1.5 T - A

SD oiol ,__ _ .___ _,

CS 3i

1.0 T - ,

SD 0 0;_ _ ..

CS

* 3.0 T - -

SD ,o

6.0 T -

SD tq

CS ~213L9

11.4 T - -

SD ,0 OO3.

CS22.8 T - - r

SD *0 1 ,o_ _

.... _______ LEFT EYE

os cj- 6..r

.5 T - , L -- £

__ _ _ SD :,O YI' ,0__ __ __ _CS

1.0 T - - ,

SD ,0 L ,O._I

CS .

3.0 T - 1.

* SD o_- ,01/

CS s-. si.

6.0 T - [.- -

SDo_ _ _ _ _ _-

* CS 3,7 31.3,11.4 T - , 9 - /, S-a I

SD Oq r _________

CS 13,w 22.8 T I,151- ,ll'V -s y

T=Contrast ThresholdSD=Standard Deviation 'I E

___________RIGHT EYE


* Frequency

CS ;20.

.5 T -- /

____ ____ SD _ _ _ _ _ _ _

CS H

1.0 T - ISD .1 ,07

CS _I/'

3.0T-__ _ _ _ _ SD __ _ _ _ __ _ _032

Cs-

6.0 T -~i~

SD i__ _ _ _ _ _ _

CS

11.4 T - jf~

SD __ _ _ _ _ _ _

CS22.8 T - I-;L

SD

__________LEFT EYE

CS /"~

.5 T *-

__ _ __ _ SD ,O' __ __ __ __

CS .

1.0 T___ __ __ SD ,o4 f_ _ _ _ _ _ _

3.0 T A

SD ,o4 _ __ _ __ _

CS /S-, ji-

6.0 T a 2.1

__ __ __ _ SD '07?' OY__ __ _ _

11.4 T I s- .0

__ _ __ _ SD to;-___

CS 3522.8 T - -

.,3qP. n

T=Contrast ThresholdSD=Standard Deviation 46F

RIGHT EYE


* FrequencyCS 17.3 )?1

.5 T - / /- lij

___ SD .lf ,lSt CS 9,vS

1.0 T - / ,_

SD OsO

CS 4

3.0 T - -

SD

CS -j

6.0 T -

SD , z

CS y/111.4 T - i3

SD (39 .oc11

CS IL(. (oLI

22.8 T "1,0

SD , I o-Y

LEFT EYE

CSIs.

1.5 T - 1.6- -

SD ,_L/ _- ,o -

1.0 T - -

SD I _ _ _ _ _,_ °_ _ _

CS 2 j~3.0 T - /. d(?

SD , "I,/

CS _3.,

11.o T _ -

SD II

22.8 T - /.i(-- -

3D

T=Contrast Thre;holdSD=Standard Deviation 46G

RIGHT EYE


Frequency

CS 1 (? ,

Cs __,. -,.5 T - -

SD ,rIo- ,_ I _ _

CS

3.0 T _ 3S _ ,,_______SD /011-.0'

CS

6.0 T ,

SD ,0*3

Os *.i i,.11.4 T - -

SD ,>71CS i.

22.8 T - 1.067 - .8l'

SD ,o9 ,.0___"____

LEFT EYE

os 9.9

.5 T -2- 2.j.S " --,o3

SD .ty .o_

Cs 30o, _

1.0 T - -

SD .o'4 ,) 3

Cs ' .'.

3.0 T - f.o; -

___ __ __ SD .03( _ _ _ _ _ _

Cs /5 - I

11.4 T -/r" - .3 .C-

SD ,o .oq,

CS

~~ ~22.8 T .g-

T=Contrast Threshold 7- SD=Standard Deviation 46H

RIGHT EYE


Frequency

CS -- 1..5 T - S . -. , 13_.

__ _ __ _ SD .__ __ _ __ _ _ __ _ __ _ _

9CS 31s

1.0 T - , ., 5"

SD , O 3 ,Cq3

3.0 T - - i '?

SD ,),1-.cs 3 .1,lq

6.0 T - /

SD o,

CS /S-. fs7

11.4 T - ,3,L - / -

SD ,IJ? III/

22.8 T - o7 -

SD ,O i ,13

LEFT EYE

CS 1,3

.5 T - (,I --L'SD ,071 ,_ o __-

CS .27.1

1.0 T - /,S- -

SD ,113. ,02etcs to, n ,,7

3.0 T - -

__ _ _ _ SD Cf __ _ __ _ _

cs 7,? 13,'?

6.0 T - - 1.1?

* s/0'" ~~~SD, t .o7

* 22.8 T-. 11., T. ' O,( ,

]rD ... ...

T=Contrast Threshold* SD=Standard Deviation 461

RIGHT EYE


* Frequency

CS I/..5 T -121_.- - .07

____ ____ SD ./I_ _ _ _ _ _ _

9 CS

1.0 T --

SD .0Mb /__?_,

CS )~j/.:9

3.0 T - '

SD ,od .o__ _ __ _

cs , __- ,

6.0 T t- 9-2- -

SD

CS q L,11.4 T l ,- /.?

SD c016 _ __ __

cs I'!(%

22.8 T Y- -

SD IL

LEFT EYE

CS

SD, ,o?

1.0 T a

3.0 T I.i - - .00V

SD .i2- , ,OiCs 7I. -

6.0 T , /. 'L .

SD .06

11.4 T /.7r -

SD ._ _ _ _ .__ _ _ _

CS .

S1 22.8 T -- ,10._ ,~~o 1.3

T-Contrast ThresholdSD=Standard Deviation 46J

RIGHT EYE


* Frequency

CS__

.5 T-

SD , _03

f CS ZV

1.0 T - -

SD co7- . V

CS -3.0 T - .I7 - V1o0

SD

CS-6.o T - 1,-

SD

CS

11.4 T - -

S O__ _ _ ,cr3 , io S

CS22.8 T / -

SD ,O? 0

LEFT EYE

.5 T -

SD__ _ _ _ _ _ _ _ _ _ _ _

cs S-0. y

_ _ _ _ _ SD ,f. ,O6. et)

cs s-, L -. .1.0 T - 70.x -

SD ,O/ ,/-I

CS1.0 T - - ,i.ooL

SD ,O'W ,_ _ _ _

S CS11.4 T - /

- ~SD , o

46K

10 RENO% PROM fla. IOSTAT09

30 E ILLOWS FOR ERROR CORRECTIONS AD RESTART OF THE PROGAM40 DIN X[25],Y[2550 PRINT *PROG$ TO CLCLATE CORRELATION COEFFICIENT AND A T-TEST"60 PRINT *OF SIGNIFICANCE OF NS"70 PRINT 'STOP INPUT OF DATA BY TYPING 1001 AS A VA.tE"s0 DIN T$KIOUS[O]90 LET J1w0,K-, K2,,NO, ,L0,J2=0100 LET LI=O,L2=,Tl=O,T2sO110 PRINT *TYPE LABE OF FIRST SET OF DATA';120 INPUT TS130 PRINT "ENTER A DATUM ATER EA CH140 FOR 1-O TO 255150 LET L=L+1160 INPUT X[I];170 IF X[I]=1001 WOTO 270180 LET *1*+190 E N IS THE INER OF DATA IN THE SET200 REM L IS TIE NUMBER OF DATA PER LINE ON THE TERMIAtL210 IF L05 0TO 240220 LET L-O230 PRINT240 NEXT I250 PRINT "TOO MAW VA UES"260 STOP270 PRINT "(13)ENTER 1 FOR CWNGE, 2 FOR NO C10NOE';260 INPUT C1290 RE Cl IS THE SIGNAL FOR 0O0E OR NO C10NOE300 IF C1-2 CT; 460310 FOR I1=1 TO N320 PRINT 'WICH ENTRY DO YOU WISH TO OW(G?'330 PRINT FOR EXAIIE: 4TH ENTRY TYPE 4'310 I UT 12350 IF 12-99 OOTO 460360 PRINT 'OLD VALUE IS "ITs1"(';12;')';XII2-1]370 PRINT 0(13) IER E VALUE"390 REM 12 INDICATES WHICXi DATA IN THE SET TO BE CWG390 INPUT 12400 1toX2 ISNEIW E410 PRINT '(1304PEAT AS IECESSAY; TYPE 999 TO END CWIGE"420 LET 1[12-1]42430 tM ASSIGN to VLUE TO THE (12-1)TH I IN THE NOY440 tE SINCE THE FIRST # STMTS IN THE 0TH POSITION450 NEIT II460 PRINT " MR IS THE SET OF DATA YOU JUST ENTERED"470 FOR Hal1 TO N460 PRINT T$1'(':1i')'IX[II-1I490 NET II500 PRINT '(13>TYKPE6 OF SECOI) SET OF DATA':510 lowU uM

!

46L

520 PRINT ENTER A DATUIM AFTER EAC ?o530 LET LaD540 FOR 1.0 TO NI50 LET LI..560 INUIT YEl;570 IF Y(IJ.1001 GOTO 640SO0 IF LOS OOTO 610590 LET L=O600 PRINT610 NEXT I620 IIUIT C630 IF Cm1001 OOTO 670 *,/

640 PRINT650 PRINT "X'S DO NOT EL Y'S"660 STOP [670 PRINT (13)ENTER 1 FOR aWK 2 FOR NO cWGE';680 IWNUT Cl690 IF C1=2 GOTO 820700 FOR 1=1 TO N710 PRINT "'IICH ENTRY DO YOU WISH TO CiWdE?"720 PRINT "FOR EXWIPLE: 4TH ENTRY TYPE 4"730 INPUT 12740 IF I2.999 OOTO 820750 PRINT *OLD VALE IS " US;'(';2;')=;Y[I2-1J760 PRINT "(13XNTER NEW VLUE"770 INT Y2790 RM Y2IS NEW .AUE790 PRINT "RPEAT AS IECESSARY, ENTER 999 TO END 0W1 "600 LET YEI2-1]"Y2810 NEXT II820 PRINT (13IHIERE IS THE SET OF DATA YOU JUST ENTERED"930 FOR 11-l TO N640 PRINT U6;S(';Il;')="YEII-1I950 NEXT I1660 FOR IsO TO N-I9 LET JIJI+Xl]SO LET K1=KI+XCIIA2890 LET J2J 2.yCl900 LET K24,2+YiJ"2910 EXT I920 LET LIzJIA21N930 LET L2,22/N940 LET YIafK1LI)I(N-l)9 LET YVZ(K2-L2)/(N-I)960 LET SlaR(VI)97 LET S2.SU(V2)90 LET Nl/INM90 LET P2-k2/NI00 FOR I.0 TO N-I1010 LET TI-TI+(ICI-I)A2,T2-T2+IY[II-2)'21020 LET I4(IC]-l)*(Y(IJ-.!2)

.. . . .. S . .. .. .. ..n .-. .

D 46M

1030 NEXT I1040 LET C41/SOR(TI*T2)1050 PRINT1060 PRINT INLIMER OF VALUES OM1070 PRINT1060 PRINT ,',IEEST. DEV.','VR.m,'SWU OF SO.*1090 PRINT TS,NI,SI,VI,KI-L"1100 PRINT UII2,2,V21 2-L21110 PRINT1120 PRINT OCOIRELATION COEFFICIENT = ";C1130 LET J.O,KuO1140 FOR 1=0 TO N-I1150 LET Z=X(I1-Y[I]1160 LET J=J+Z1170 LET Kz(+Z*Z11 O (EXT I1190 LET L=J§J/N,V-(K-L)/(N-1),SxSR(V)1200 LET N.J/N1210 LET TItI(S/S R(N))1220 PRINT "(13)IRS..TS FOR DIFFE CS(3)EAN';N;' STD DEV-';S;1230 PRINT a VIYR-'*?" SS=';K-Li(13)T =';T1240 PRINT "(13ENTER 1 FOR CONTINUE 2 FOR END,1250 INPWUT C21260 1EN C2 IS THE SIGNAL FOR CONTINUE OR END1270 IF C221 GOTO 9012908B

iL

.Si~

* 47

APPENDIX G

SANVAR PROGRAM

10

* ~47A

10 PRINT 'SINGLE FACTOR ANAYSIS OF VARIANCE FOR REPEATED MASJRES20 PRINT " (ONE-WAY)'-.30 PRINT40 REMI SIZING THE MATRIX AND DATA INPU~T50 PRINT "ENTER THE NUMBER OF TREATMENTS-60 INPUT K

8I7T0 PRINT 'HOWd MANY ELEMENTS ARE THERE PER TREATMENT"; *90 PRINT *ENTER THE DATA ONE NUMBER AT A TIME, STARTING WITH THE DATA-;100 PRINT aIN ROW ONE,"

110 PRINT 'THEN GOING ON TO THE DATA IN ROW TWO, AND SO ON. 4.

130 PRINT140 DIM XfN,KJ,YfNKJ,UfN),5fKJiii INPUT "WOULD YOU LIKE THE FAST OR PROMPTED FORMAT? I=FAST, --PRCWTE-D".29142 IF Z9--l GOTO 202150 FOR NI=1 TO N155 PRINT OENTER SUB&[CT ";NI;"FIRST VALUE, SCOND VALUE,156 PRINT160 FOR K1~l TO K170 PRINT 'DATA "

180 INPUT XENI,KIJ190 NEXT KI20 NEXT NI201 GOTO 220202 PRINT203 PRINT m ... *. MAY YOUR DATA BE SIC IFICANT)*h*.** .*204 FOR N1=i TO N205 FOR KIl TO K206 PRINT 'DATA 0;207 INPUT XENI,KI]208 NEXT 1(1209 NEXT Ni210 PRINT22 PRINT TAB(15);rDATA'230 MTY PRINT X240 PRINT250 PRINT *TO IWE COWCTIONS, ENTER ROW No., OTHERWISE TYPE--;260 INPUT Ll270 IF L10O GOTO 450280 PRIN4T *ENTER COLUMNd NO.*;290 INPUT WI300 LET N1=Li310 LET KIzWI320 PRINT "DATA';330 INPUT XCLI-WdI340 PRINT RANY MWE CORRECTIONS ? (TYPE I FOR YES, 0 FOR NO)";p350 INPUT I360 IF 1-0 GOTO 380370 GOTO 420

4

47B

0 PRINT0 390 PRINT TAU(IO);'COIECTED DATA"

400 HT PRINT X410 OOTO 450420 PRINT ROW NO.';430 I PUT LI440 6TO 270

1 450 REM TAKING THE S OF . F THE DATA460 FOR Ni=! TO h470 FOR k1l TO K480 LET Y[1h,Kl]=X[Ni,Kt)"2490 NEXT KI500 NEXT Ni

*510 LET 6-520 REM G= THE RMD TOTAL 1:530 LET R=O540 REM R- THE OF P S E550 FOR NI1= TO N560 FOR K=l TO K570 LET Pi--PI+X[I1,Kj390 REM PI=P- THE RM OF TtE DATA IN THE ROW590 NEXT KI600 LET 0O+P1610 FOR Ul=I TO N620 REM U= THE A" OF P630 LET U.P1A2640 NEXT Ul650 LET R=Ri660 LET P1=0670 NEXT Ni680 LEET H=)690 REM W THE MANE TOTAL700 LET W.710 REM0- THE " OF T S0L#ED720 FOR KI=l TO K730 FOR Ni=! TO N740 LET TI=TI+XNIKl)750 REM T-TI=HE SUN OF THE DATA IN THE COLiN760 NEXT NI770 LET HzH+TI780 FOR Sli TO K790 LET S=TIA2800 RI x11SHE SOM OF T

- 810 NEXT S!820 LET GQm+5

30 LET TI=0840 NEXT KI

0 LET JlO860 R JI=THE SOhI OF THE SUES OF EACH OF THE DATA

$ 870 FOR KIl Tl K860 FOR NI-z TO N

4L

• 47C

890 LET JI=JI+Y[NI,KI-* 900 NEXT N1

910 NEXT KI920 PRINT930 REM THE MEAT OF TE SU&JECT (BELOW)940 LET A=V"2t (KIN)950 LET B=uI960 LET C=Q/N970 LET D=R/K

S 980 LET Vim"M, LET V2=B-D

1000 LET V3=C-A1010 LET V4B-C-D+A1020 LET V5=9-A1030 LET EI=N-11040 LET E2=N*(K-1)1050 LET E3-K-11060 LET E4=(N-1)(K-1)1070 LET E5=(K*N)-I1080 LET NI=3/E31090 LET fl2=V4/E41100 IF M2=0 OTO 11201110 LET F=Ml/M21120 PRINT1130 PRINT TA(18);SOURCES OF DEGREES OF MEAN F"1140 PRINT TAB(18)*;VARIATION FREEDOM SOU VALLJ1150 PRINT1160 PRINT "BETMEEN TREATENTS';VlTA9(40);E11170 PRINT "WITHIN TREATMENTS ";V2TAB(40);E2118O IF 'M200 GOTO 12101190 PRINT "TREATMENT ";V3;TAB(32);E3;TAB(46);MI;TAB(60);"F UNDEF."1200 GOTO 12201210 PRINT "TREATIENT ";V3;TAB(32);E3;TABI46);HI;TAB(60);F1220 PRINT 'RESIDUA l ;V4;TAB(32);E4,TAB(46);f'21230 PRINT ' TOTAL ";VS;TAB(40);E51240 REM PREPARED BY ALAN RHODES, 19781250 END

I°4

9 48

APPENDIX H

tTEST (RELATED MEASURES) PROGRAM

48A

10 PRINT PFROG TO CA.CU.ATE MU NO PROINCTS OF THE DIFFEJECE INO20 PRINT 'INED DATA POINTS NO SILENT'S-T WME(13.30 PRINT 'WE 1001 FOR X TO STOP THE IMVT OF VALUES'40 LET NL"O,"O,Jw0,K-O50 FOR I"0 TO 2560 LET L4.+l70 PRINT " Xzu*80 INPUT Z,90 IF Z-1001 GOTO 200100 PRINT " *=ol110 I JT Y;120 LET X=Z-Y

* 130 LET Nm+140 IF L03 OOTO 170150 LET LwO160 PRINT170 LET JJ+X180 LET K=K+X*X

S190 NEXT I200 LET LJ=*M210 LET Ys(K-L)/(N-1)220 LET SSWR(V)230 LET 1IJ/N240 PRINT "3)N=;N" ';M;* S=;S'" V*- ;V;' SS=N;(K-.)250 LET TzN/(S/SOR(N))260 PRINT "T-LtIE=8|T270 END

S/

* 49

4* I

APPENDIX I

DATA COLLECTION SHEETS (DESCRIPTIVE)

S

......... 4 II 49A

Ago 0

BASELINE

Distance Acuity

Spectacle Rx: OD -. -. 0 20/1-

OS , ', ,,- kO0. 20/ lf

Pupil Diameter: OD SC mm

0S 4,0 mm3

DISPENSTNG

Contact Lens Rx: OD - CS-r

OS Distance Acuity(thru over refraction)

Over Refraction: OD ~o 20/s--'

OS 20/IS- -

Wearing Time: / '- Spectacle Acuity(post CL wear)

Pupil Diameter: OD Co mm 20/ ,r-

OS mm 20//9-

ONE WEEK

Distance Acuity (thru over refraction): OD 20/ /S--'

OS 20/ fi'

Wearing Time: Y 4GI Spectacle Acuity(post CL wear)

Pupil Diameter: OD 9^o mm 20/ /r

OS .O mm 20/1c'

ONE MONTH

Distance Acuity (thru over refraction): 00 20/ I/- -2

OS 20//f

Wearing Time: /- Spectacle Acuity(post CL wear)

Pupil Diameter: OD SrO mm 20/ /4

OS mm 20//S"

Si

S?

WI lii _ ____ ____ ____ _ _/Ii 49B

Ago2..

BASE1 ] NEDistance Acuity

Spectacle Rx: OD +I,7OC S-c. Kc qO 20//--

Os .tj4a -C,1.OtqC /J.t

Pupil Diameter: OD q.Smm

OS .mm

DISPENSING

Contact Lens Rx: OD +-4,00 C -

OS 4-1-. " Distance Acuity(thru over refraction)

Over Refraction: OD -o.-O S 20/ IS-'

OS - -o sl1 20/ -o;0

Wearing Time: / 4 oaW Spectacle Acuity(post CL wear)

Pupil Diameter: OD Y.,'mm 20/ IS-'

OS .rmm 20//!- 3

ONE WEEK

Distance Acuity (thru over refraction): OD 20/,.O -!

OS 20/,-O-

Wearing Time: Spectacle Acuity , .1

(post CL wear) ,

Pupil Diameter: OD SO mm 20/IS-I

OS 9-.o mm 20/4-0'

ONE MONTH

Distance Acuity (thru over refraction): OD 20/.40"

OS 20/.4W

Wearing Time: 40( Spectacle Acuity(post CL wear)

Pupil Diameter: OD '.0-mm 20/ I --"

OS 201.-*

!.

...., . . I I .. I I . . . . .... .. . . . . . . . . . . . . . . .. 1

Ago Z 49C

BASELINEDistance Acuity

Spectacle Rx: OD S-/.O -O. k /60 2011s-

OS -/,- .o 20/,-

Pupil Diameter: OD q,-5mm

OS V' mm

DISPENSING

Contact Lens Rx: OD -o riof- - -


Over Refraction: OD - Of-o X L3r 20/ r-

OS p 0 oO 0o 20//S.r'-

Wearing Time: / It- Spectacle Acuity(post CL wear)

Pupil Diameter: OD S. mm 20//we

OS Yimm 20//s"

ONE WEEK

Distance Acuity (thru over refraction): OD 20//S - '

OS 20/t -'

Wearing Time: 1 Spectacle Acuity(post CL wear)

Pupil Diameter: OD$ 0 mm 20/ /s

OS SC0 mm 20//

ONE MONTH

Distance Acuity (thru over refraction): OD 20//"--

OS 20//C"X

Wearing Time: l 4o4? Spectacle Acuity(post CL wear)

Pupil Diameter: OD r'mm 201S-

OS Y.1 mm 20/ l

C;

S8'

l l__ _ _ _ __ II 49D


Spectacle Rx: OD /-oO, o - 20/- ".OS -I.Or"04l 2ol IS-"

Pupil Diameter: OD Y.0 mm

OS q.O mm

DISPENSING

Contact Lens Rx: OD -/.k

0S -/'- Distance Acuity(thru over refraction)

Over Refraction: OD -0,I" 20/,2o

0S -04s- 20/.20*+

Wearing Time: / e Spectacle Acuity(post CL wear)

Pupil Diameter: OD .' n.,i 20/ /.r-

OS V-Ymm 20//Jr

ONE WEEK

Distance Acuity (thru over refraction): OD 20/;V"

OS 20/,L&* z

Wearing Time: ,) , & Spectacle Acuity(post CL wear)

Pupil Diameter: ODj.f mm 20/ C-

OS Y.9- mm 20/ /S"

ONE MONTH

Distance Acuity (thru over refraction): OD 20 /.Ic't3

OS 20/Xc+3

Wearing Time: 4 /z Spectacle Acuity(post CL wear)

Pupil Diameter: OD W m 20/lAr

OS V'-mm 20/IJ"

- I.

i ...... ._ _ _

Name # 49E

Age 2?

BASELINE Distance Acuity

Spectacle Rx: OD --/c Aci

Os - A1 0 20//S-

Pupil Diameter: OD uV mm

* OS S70 mm

DISPENSING

Contact Lens Rx: OD -1.00

OS -. 00 Distance Acuity(thru over refraction)

Over Refraction: OD to 20//S"

os *o, , , 2o/1S"

Wearing Time: / ieo- Spectacle Acuity(post CL wear)

Pupil Diameter: OD mm 20//S-i

OS _mm 20//-/

ONE WEEK

Distance Acuity (thru over refraction): OD 20//1-'

OS 20//.r

Wearing Time: ' Spectacle Acuity(post CL wear)

Pupil Diameter: OD 7o mm 20//4

OSro mm 20/1

ONE MONTH

Distance Acuity (thru over refraction): OD 20//,r

OS 20/ /S

Wearing Time: S- Specta, , Acuity(post CL wear)

Pupil Diameter: OD9. mm 20/ Ir

OS 2o mm 20/ /4-

,.J

Nnmo __ 49F

Ago 3


* Spectacle Rx: OD -c--.C",'4 20//f'-

os-/,--' 20//-,r"'

Pupil Diameter: ODSf".C mm

9 OS S( mm

DISPENSING

Contact Lens Rx: OD ,J_

os - Distance Acuity(thru over refraction)

Over Refraction: OD At., 20/ /-

OS 1 ).C 201

Wearing Time: / 4d '" Spectacle Acuity

(post CL wear)Pupil Diameter: OD r.6 mm 20/IS-

OS9--0 mm 20//.r

ONE WEEK

Distance Acuity (thru over refraction): OD 20/IS

OS 20/S

Wearing Time: 3 4,,rs Spectacle Acuity(post CL wear)

Pupil Diameter: ODr-o mm 20/-

OS S. mm 20///-

ONE MONTH

Distance Acuity (thru over refraction): OD 20/I '

OS 20//1-

Wearing Time: 5" z Spectacle Acuity: , (post CL wear)

Pupil Diameter: ODrO mm 20/(s L

OS ,mm 20/ /Sr "

SW

Nmm_____________ 49G

Age ~


Spectacle Rx: OD 0,&-. A /S-0 20/,J-

Os ~as~~~- 03( ) 20/i'-

Pupil Diameter: OD ~mm

OS m

DISPENSING

Contact Lens Rx: OD

OS S~ # A Distance Acuity(thru over refraction)

Over Refraction: OD 4 CeZr -o.C Xto 20/ -2ct

OS 4--2 -20/1S-

Wearing Time: Spectacle Acuity(post CL wear)

Pupil Diameter: OD, SC mm 20//x-r

OS -c mm 20/

ONE WEEK

Distance Acuity (thru. over refraction): OD 20/4J-

03 20//IC

Wearing Time: ~/46,-xs Spectacle Acuity(post CL wear)

Pupil Diameter: OD rC mm 20//SC

OS cmm 20/ts

ONE MONTH

Distance Acuity (thru over refraction): OD 20/.10+3

OS 20/Id~

Wearing Time: '(49ce-t Spectacle Acuity(post CL wear)

Pupil Diameter: ODSgC mm 20//Ar

OS-5,omm 21S

Nae ____ 49H

Age 3:-


* Spectacle Rx: OD -. .S -'42

OS - o 005- 20/. *

Pupil Diameter: OD '.'mm

OSY. mm

DISPENSING

Contact Lens Rx: OD - ,


Over Refraction: OD 20/4o1

os 20/.&-'

Wearing Time: / 4 Spectacle Acuity(post CL wear)

Pupil Diameter: OD mm 20//.I

OS .- 20/ /

ONE WEEK

Distance Acuity (thru over refraction): OD 20/ AE -_

OS 20/ /f-

Wearing Time: L 4 ccei Spectacle Acuity

(post CL wear)Pupil Diameter: OD .Sf mm 20/,;2o1

OS ). -mm 20// S ' -

ONE MONTH

Distance Acuity (thru over refraction): OD 20/ /S--

OS 20/,I "!

Wearing Time: 4@,; Spectacle Acuity(post CL wear)

Pupil Diameter: OD Y,9Amm 20/(o Cwa

OS f mm 20/, '-

D

Namo # 491

Age 4-3)


* Spectacle Rx: OD 20/ is-OS -J %-O x 100

Pupil Diameter: OD S0 mm

OS !2o mm

DISPENSING

Contact Lens Rx: OD ,


Over Refraction: OD /0 20/ ,o

OS O1G 20/ "-

Wearing Time: ) LC" Spectacle Acuity(post CL wear)

Pupil Diameter: OD S:,O mm 20/ Is--

OSSo mm 20//A:-

ONE WEEK

Distance Acuity (thru over refraction): OD 20//-

OS 20//,-

Wearing Time: q 4,"r Spectacle Acuity(post CL wear)

Pupil Diameter: OD&O mm 20//S-

OS .CO mm 20//-

ONE MONTH

Distance Acuity (thru over refraction): OD 20//r-

OS 2o//-1-


Pupil Diameter: OD 97o mm 20/ /.i

OS ,O mm 20/L6

a

S

Nnr_,o # 49J

Age ;21


Spectacle Rx: OD -6, , -O,-OX 0.- 20/js-

Os -t, o -o,,S'x0o 20/1

Pupil Diameter: OD N-0 mm

OS r- O mm

DISPENSING

Contact Lens Rx: OD - 0

OS - Distance Acuity(thru over refraction)

Over Refraction: OD 20//#S-

OS t o201-'

Wearing Time: 4 1oi Spectacle Acuity(post CL wear)

Pupil Diameter: OD 90 mm 20/ Ir

OS '0 mm 20//

ONE WEEK

Distance Acuity (thru over refraction): OD 20/1

OS 20/- '

Wearing Time: ( 4 Spectacle Acuity(post CL wear)

Pupil Diameter: OD5.( mm 201ls-

OS &-.0 mm 20/IJ

ONE MONTH

Distance Acuity (thru over refraction): OD 20/ I/'1

OS 20/IS -

Wearing Time: o Spectacle Acuity(post CL wear)

Pupil Diameter: OD .O mm 20/

OS mm 20/c'*

r4

(.

Namo I49K

Agoeo


Spectacle Rx: OD -- . - X030 20//I -f

OS 20/(f "-

Pupil Diameter: OD .0 mm

OS S-0 mm

DISPENSING

Contact Lens Rx: OD -I.


Over Refraction: OD o. - - 030 20//I-

OS 0 0k00 201 -

Wearing Time: L. - OL - Spectacle Acuity(post CL wear)

Pupil Diameter: OD C 0 mm 20/f - L

OS 9. 0 mm 20/

ONE WEEK

Distance Acuity (thru over refraction): OD 20//-t

OS 20// &--


Pupil Diameter: OD S mm 20//1--

OS So mm 20// -

ONE MONTH

Distance Acuity (thru over refraction): OD 20/I- "--

OS 20/ /.r

Wearing Time: . ot -'c Spectacle Acuity(post CL wear)

Pupil Diameter: OD.C.0 mm 20/ pr"-Ij ~ OSCO mm 20//

L. WOMEN

Nnro_// 49L

Ago tjL

Distance Acuity* Spectacle Rx: OD 20//s-

OS -/,r -O A 1.0 20

Pupil Diameter: OD Sco mm

OS r0 mm

DISPENSING

Contact Lens Rx: OD - ,S- - T-

0 S Distance Acuity(thru over refraction)

Over Refraction: OD 20/ 1'-1

OS 20/r'

Wearing Time: 1 4 ".- Spectacle Acuity(post CL wear)

Pupil Diameter: OD.o mm 20 wer

OS .o mm 20/Is"

ONE WEEK

Distance Acuity (thru over refraction): OD 20/f-

OS 20//3S

Wearing Time: Y I Spectacle Acuity(post CL wear)

Pupil Diameter: OD 57o mm 20/ ,.r

OSf fo mm 20/

ONE MONTH

Distance Acuity (thru over refraction): OD 20//S-

OS 20/ t-

Wearing Time: / Spectacle Acuity

(post CL wear)Pupil Diameter: OD 2mm0/ w20/

OS ' 1 201m-

Si

___49M~~Age QV --


Spectacle Rx: OD 20/1s-

os -a, "04 2o/i"

Pupil Diameter: OD , rSmm

OS £' mm

DISPENSING

Contact Lens Rx: OD -J,--


Over Refraction: OD 20/ /

os 20/ f

Wearing Time: ) 4c'v Spectacle Acuity(post CL wear)

Pupil Diameter: ODS 5- 5mm 20//x-

OS Smm 20/ ,-

ONE WEEK

Distance Acuity (thru over refraction): OD 20/IS'

OS 20/ i-

Wearing Time: ' 4 Spectacle Acuity(post CL wear)

Pupil Diameter: OD rTo mm 20//S"

OS r0 mm 20//"-

ONE MONTH

Distance Acuity (thru over refraction): OD 20//'

OS 20/ IS

Wearing Time: q 404C--9 Spectacle Acuity(post CL wear)

Pupil Diameter: OD S.r9mm 20/

OS 20,mm0

4

..

nowV

Namo___________ / 49N


*Spectacle Rx: OD seC~ ,4 20/ IS-

os 4-; j- 20/ 1,

Pupil Diameter: ODI-C mm

* OS rC mm

DISPENSING

Contact Lens Rx: OD .S

OS Distance Acuity(thru. over refraction)

Over Refraction: OD io~io20/ /s

OS 2~4C 20/ /

Wearing Time: /tu Spectacle Acuity(post CL wear)

Pupil Diameter: OD S;0 mm 20/ is-

OS o mm201-

ONE WEEK


OS201

Wearing Time: ' 4owrs Spectacle Acuity* (post CL wear)

Pupil Diameter: OD'f.S mm 2/S

ONE MONTH

Distance Acuity (thru over refraction): OD 20/ /s-

OS 20/,,to"

Wearing Time: Cu 4 o- j Spectacle Acuity(post CL wear)

Pupil Diameter: OD S.O mm 20/ /S-

OS 2 mm 20/

Nnmo 490

Age (/---


*Spectacle Rx: OD - /. s5 ' 20/ /.C

Pupil Diameter: OD 3. Smm

*OS I -- m

a DISPENSING

Contact Lens Rx: 'OD /7Q T7.

OS /.0 Distance Acuity(thru over refraction)

Over Refraction: OD *-'~r20/ Is-

Wearing Time: / oaSpectacle Acuity(post CL wear)

Pupil Diameter: 0D 3 S-mm 0Ioft

OS 3.Smm 20/ t6

ONE WEEK

Distance Acuity (thru over refraction): OD 20/1S ~

OS 201I-1

Wearing Time: Y( 4'.J Spectacle Acuity

(post CL wear)Pupil Diameter: OD'If.() mm 21t

ONE MONTH O 1 m2//:

Distance Acuity (thru over refraction): OD 20/ IS -,

OS 20/ /;-

Wearing Time: '/~Spectacle Acuity(post CL wear)

Pupil Diameter: OD 'j-0 mm 20/ /,,g )-

OS 1.0mm 20/ 1 s

Age -t

BASELINE ,.Distance Acuity

Spectacle Rx: OD -O.s 20//1

OS +0.77--. zr- 20//W

Pupil Diameter: OD .0 mm

9 OS '-:*o mm

DISPENSING

Contact Lens Rx: OD Li,5-0.

OS -4-O.'?S" Distance Acuity(thru over refraction)

Over Refraction: OD -0,e - 20/ /-

OS 20/ /S-

Wearing Time: / e.r:- Spectacle Acuity(post CL wear)

Pupil Diameter: OD 2U mm 20/ ir-

OS .(J mm 20//s-

ONE WEEK


OS 20//

Wearing Time: q 40/oc-S Spectacle Acuity

(post CL wear)Pupil Diameter: ODV,1'mm (po20/ is-

OS /.s mm 20//S-

ONE MONTH

Distance Acuity (thru over refraction): OD 20/ /IS

os 20/'S

Wearing Time: ' t Spectacle Acuity

(post CL wear)Pupil Diameter: OD YJKmm 20//J-

OS 'mm 20//S

Nnmo____________ I 9#o 49Q


Spectacle Rx: OD - 4, f" 20//1s

os - 20/

Pupil Diameter: OD 5 mm

* OS S.rmm

DISPENSING

Contact Lens Rx: OD -L/. 0 wOS - 7 Distance Acuity

(thru over refraction)Over Refraction: OD (,tg o20/j-

OS -,20/1S-


Pupil Diameter: OD s,.S-mm 20//j-

OS -mm 20//-

ONE WEEK

Distance Acuity (thru over refraction): OD 20//-

OS 20/1W


Pupil Diameter: OD - mm 20/ /a-

OS .mm 20/

ONE MONTH

Distance Acuity (thru over refraction): OD 2011Wr

OS 20 1 /

Wearing Time: -5- Spectacle Acuity(post CL wear)

Pupil Diameter: OD 0 mm 20/,r

OS o mm 20/£

S,,

Naiwio / 49R

Age 0,11

IHAS3;1, I NIEDistance Acuity

# Spectacle Rx: OD -2. S--,- XhYL) 20/ /

OS 20//S-

Pupil Diameter: OD Y.Pmm

OS '/ mm

DISPENSING

Contact Lens Rx: OD -,


Over Refraction: OD 201 ,Zo 7

os f '(" Co (- -

Wearing Time: / 4c .- Spectacle Acuity(post CL wear)

Pupil Diameter: OD '.-mm 20//-

OS m, 7rm 20/ / T

ONE WEEK

Distance Acuity (thru over refraction): OD 20//S -'

OS 2 0 //r

Wearing Time: q Spectacle Acuity(post CL wear)

Pupil Diameter: OD./-mm 20/L ar

OS m. -mm 20//S--

ONE MONTH

Distance Acuity (thru over refraction): OD 20//, -'/

OS 20/fr

) Wearing Time: '(IL 4 .Or. Spectacle Acuity(post CL wear)

Pupil Diameter: OD Y.rmm 20/ /1r

OS q.smm 20//-

S

I

NZ . . . 49S

Alle

HAS.I3 , I NIDistance Acuity

Spectacle Rx: OD - i.%'0 20//r"

os A 20/

Pupil Diameter: OD .omm

0S . mm ,

DISPENSING OS

Contact Lens Rx: OD _', 0 b

44..

9OS Distance Acuity(thru over refraction)

Over Refraction: OD , 20/ /S-

OS 2011C


Pupil Diameter: OD 4,Jmm 20/,J-

OS '" mm 20//'-

ONE WEEK

Distance Acuity (thru over refraction): OD 20//JI

OS 20//f


Pupil Diameter: OD )' mm 20/ i-

OS mm 20/ i5)

ONE MONTH

Distance Acuity (thru over refraction): OD 20//-"

OS 201/ S'

Wearing Time: j A Spectacle Acuity(post CL wear)

Pupil Diameter: OD ',Y mm 20/ii

OS mm 20/ If -'

* 50

*

APPENDIX J

DATA COLLECTION SHEETS (TEST RESULTS)

II

T=Contrast ThresholdSD=Standard DeviatJon 5OA

RIGHT EYE

Spatial Dispensing One Week One MonthBaseline

* Frequency CL Removed CL Removed CL Removed

CS . 3y,.C ZT 3Z.7 /.12 a- 64P. 35 T -/Ij.s -/."r7 -(.1h; - S.s1 - /..3 ?/. rs- -/.ys-A

SD ,0_ ,Ao. ,/1F ,0'/1' /S " lq3

1.0 T /.e,? - /.7 - /.S -/.g' -/.,y -J, gt, -/.,'7

CS /40_7 141.1 /D's 14t,3 ,/c.? T o 13a0.73.0 T - - -. O , . - A.oV - .,II7 -

SD ,(.V , A.4. .oaI os-'/ ,- 131 ,/.

.CS /,. 10S3 /o/'i 09L.. /-. /o-;3 /A6.0 T -a.of7 -.qo73 --... 0 - 1.?3C"- . I _go.3 -

SD .0CA " ,/7 ./',' ,Ay 88 ,17__1 o21_I-

CS q . z . ,. , -9 10. ; -0.y11.4 T -I 1 r - nr /6( 7 1,2 -1 J.0( - o,

SD ,o_ ,/' ,Oc ,o/-y .01. .s 07 ,Zi3

CS Y, S- 34,7? 6233 j./ AP 3T3 122.8 T S-, ? - /. 9Y3 - /.- .I Y67 - I.44.y 9 - l

SD ,tg ,IY V ,II ,133 ,S _-.P '_,f

LEFT EYE

CS a.t, 313 Y.I , .91 J1 Fa.5 Tqj t yT -I. 3." -I,"tfg - /,' ctv ' .¢" 1 ? - 131. - IYr

SD ,I1/ , 31 .1, .o1- . r , .I ,oi.F

1.0U-T /'6 /.* -.. -- - ..

SD ... _,4_ ,17 0i1 ,lo/ ,1Pj 10yl ,W4CS ys": I~ tP /0 .s /I' , / -,l i //Y. 0 . /I .. -

6.0 T - J.10- - /. I.o. -/.30 -S? o1 0 -A.oJS

SD d,1 ,0 / ,0/?( , .0cL Aor ,CS 'L.?er.vY S%- 51

_ * (.0 -,o.3 " I.1 - .o. - I,,.3 - =,..5 ,.l r ..11.4 T /.gy _l. ; _ /.-,V ? _ /.s*J- 1 1 - 1.1 - i.

SD ,is- .10,t .o ." ,o% 1r

I/o :1 tl' :=. ;193 g ,- d I ITS,

22.8 . _l,-"o - /,I SI.7O - ; - . -

aOr ,/t .or gol.f. .1

T=Contrast Threshold* SD=Standard Deviation 50B

__ _RIGHT EYE ,, ,

Spatial Dispensing One Week One MonthBaseel ine

Frequency i CL Removed CL Removed CL Removed

.5 T , - /,o?!- . - /,/t - ,'O -A.O OV

SD ./O- .07 GS ... ,O'. ,OA ,0_A.0

at CS 3P7 3. ~.~ 3;Z9 ~?S-. 1. S1.0 T - . - ,' - ,.,.,z - - /. - .eoV- i-'5

_ _ _ _ _ SD .O'4( ______ ___O___ O F/ ,- - 0" .0'? "cs ea 8 I , ?/ a4-'v

* .0 T - .1'' - 1'.? 1- /." - .? - /. "S~- _ .),' -J_ .SD . ,0l ,or- .oil ,0791 ,oy ,_!.__oS ,M

6.0 T - p - - /.*, - S.' - ).-? - 0. - "

SD .0? '; ,o ;( I ,o .o_ .O _

1.4 T 97 - - -. lX- i /W - I."SD , 7 o9 .041, .oti .oOS___ .00~fCS a.g- y3 y I ' 3 /d&7 Iy

22.8 T - /. o7 - . ' y - /. - /.3- 5"- I..,1 - /[1"1 - I

SD ,10? ,______ ,____ . ,o't( ,____ .os7 o

LEFT EYE

S3 . aos ,0/ . ,0 __

T - /., - /. - . 0I 1 - - /.03

SD ,,1os ,osI ,.O .0 1 .o V07

3.0 T - ' - /.?t - /. - - /. - /. Tn" - i, -7 - /,?,SD ,04 .o? ,oarV ,0i7 ,O.3 ,Oi _ ./Is_

6.0 T / - 1 ./? . - . r - /. U - /117SD ,o67 .1o ,oi .1'0 ,0,F ,oil ,o6

11.4 T - /. -- - /.6 - 1.e ? - /.-. -

SD .o6 ./4 .o7 ./it ,o4 ,'s '01? , i

* -'.,Ir - ./* - i//A -/,o. -40. - ,W3 - 1.O,0 ,oft lot I- op'3 ( Yr,1.03X

4094 '0jr .10 opt 0y 04; Ow

T=Contrast ThresholdSD=Standard Deviation 50C

RIGHT EYE

Spatial Dispensing One Week One MonthBaselin '"

Frequency CL Removed CL Removed CL Removed

cs 3 ,1 ,27, -I. 12o., /4 yI .2/.2

.5 T - - - /. - - - -/.R -/;|SD ,____ ,.017 ,*.. ,1fl .03) ,It

CS 4s. . S .ItI' 6 1. .f1.0 T - - - - - - /.' - .

SD .o3y ,01L s,,1 .0*- .OS' ,o-P.]

CS /104 / ,? /,,'I I Jc, I '4.i I ,1-3

3.0 T g- .o1.t - - j, - ;.iis- - .,12)- .,." -

SD OR;)_ '1L.0. .2 o~ ,1)19

CS loz.3 /OT. 4 3./ 10 I . 13/6..F H1.1 11.6,

6.0 T - 01 - ;.oy - 2. - 1.06 - .2.i3. - Z.js- - 0 ,1S£

SD .06P Id"_ ,0S 44 ,Oq. ,0"11 06,o

CS 33 .11 3571 4 ,. jo.,3

11.4 T - - - /,/.. - /.s-r - /.g3 - ,.7 .. ,

SD .06;L .01tY .213 .c' Cq'U 0o.0 .1

228 CS my ~ y~ 0 ter 16'.022.8 T - /..l- - /.I S - [.pR - .. 9,1. - i/,.I. - ,.;

SD ,0o'?O .W .O, .,oL 01, O*,*L.. ,04

LEFT EYE

5 CS 2.2, g .- 9 1 'u4. A ---- .5 ~T _ , j.,o .. - j-; - /.z.is"- . - !- " - ,/1

__ _ _D_ , o)( .IDg ______ ,____ ,O& .','" ,o

1.0.17 d/

SD ,'O ,13.0 ,1 ____ ,1_,_ ,oS ,o,1

3.0

S. T - .2.i 7 - QZ.1t1

- - Jt w 4 .,'j - d.i'~p _ Jo04 -2I3SD ,o_ ? 0 .o ,o'/R .09___ ,0 PI

CS I t. , I ?,.r f. 19Y. 11Y /vl .r 13S,-

6.0 T - 0.03" .- ,-.1.1.2

SD .0) 0_PI_ 01O]' .0- ,Of- .O3y .0l

CS 111o., P-1. I 'S eo.7

11.4 T _ - i#S- 4.? - I .- ild - " -_ _ _ SD .0,3 .o0 ,0'C . ,oi. ,aoA ,0__

T " .V* - 1.9-0" -/ . _ P , - /,'/d _ , - i.0o

,"i .0'3C ,o ,ON? ,*0'1 ,o*9 ,1121CS 61-4 413 /C _.n

T' Con tratt Thi,'- ;tto 14

SD=Standard Deviation 5uD

RIGHT EYE

Spatial Dispensing One Week One MonthBaseline0

* Frequency CL Removed CL Removed CL Removed

~~~~CS Y2 /. ~ /- , .1.1, < 1

.5 T - /.O - /. - 1. , 9S - P.IY -

SD o0,1 'I4I .oZi .qlCS s ., Y. I lt.? q qn z. t. ql~q

1.0 T - /.6.2 - 1,7a . - / - I.6'f -

SD ,o1t /_,_ .o__ ,_,__ ..0,4 ,oq .0CS" . jj

3.0 T - - 1,Y'tJ - ..o? - .o8Z - ol f ... .2.1

_______ SD O_____ ,orf -o' ___ ,~ I oZil i,

CS 16o I1o i V." ' 1, j.9 Iof. 3

6 T ;.0 0 . i.on .o . -_ .o0 - .oZ3

*SD .oS'J OS3 00b ,vL ,i oil .__CS q,.? , . ].3 ga.V2 .

11.4 T - 1,63 - ,9, - /, - " - /, ' " /t - l ]

SD ,o7 ,/'1.- .05.3 ,O Z- ,O&i. ,0f .10.3

CS . l/.S 30.- ,. a-.- , ;Y'. S22.8 T - /.A - /.o- - - / .t-,2 Lr - /.31

SD ,o0? ,OZz- ,j3, *os' ,Z' Z_ ,Oi'o ,oOf O

LEFT EYE

CS 1S / Ir - . .7

.0SD ?AL -0 ,1- jj:l .I.- I.j - .102 - .04 -I.

... .. SD air ,ll7 ,OJP ,Or? ,O7ge ,o..S /004cs '9% . 'tl Iot. io9. t /oo z "3 I .

3.o T Y- ,'fr-- o - .. o - 6.1,t - .0Z

__ _ _ SD ,10_ .o1'K .o .oS .12 .0'17 .01

CS Y'I kr. PO ~ ~6.0 T - 1.? - ,107 ,.oI - .8i, -7 , ,.ooz

SD 087 .os' ,o'Y oS0s .101 .o? o ,o

CSD ,S ,' 11.4 T - .t - /gs-r - l,. - 1.6'7 - /.?S"? _ - .l - , 1

* I .orr' .oP *. .o1 .O¢" , o*U P$ ,qf

-- 1.3t8 - I, .- s /.jT' - ,i - , - ,I VyO.y, .042- 021 , '0,if ,oi7 ,.101

T=Contrast Threshold (i-SD=Standard Deviation 50E

RIGHT EYE



CS /7,1 ,oY. ; Zz.Y a,. y 3'.5 T - ,IS3 - /.SqL I- ..30- - .9S - 1. 1

-I.1l2 -

SD ,oz ,o2. ,lie ,'1139 IZY ,2M ,____

*CS qo.- 3 V 36.7 S.? j1.0 T - /tVS- - /s- - -ys" _ /. 80

SD ,0 5T9? ,0'.2 __O.__ ,o1( ,173 .06CS /07.6 /o, /Z.1 , Y'. f A. J 3

t 3.0 T ,,.202 )- , - ,.I2, - 1it? - 2,I.5 -11,oPSD .071 , , ,O00 .o1 ,fI ,0_ ,0__

CS 90-Y /63.1 /03-S' Ify. i 87A'.6.0 T , -" , Ot - /.d~V - .,a -;.OW- - *Lr

tSD I___ ___ __ ______ oil CAI a .P '03?

CS ._.3. 1? 3 'fl.

11.4 T - .y - /.3 - .O 7 -/. - /.&07' -

SD ,0o ,0'I ,06'? ,la? ,Os" ,0s- ,Iy

CS /6,1 /2.3 /.rt /e..P - ').? /22.8 T - og - / -,3 - - 1 -/.2ZM' -

SD .023 ,097 .0o6) , (' ,.r/4 ,.c2 ,o_%,

LEFT EYEcs .1"0t .9 g 7.. f&. 2. .13 .o

T - /.ii& .3 1j- - i. Y1 31 -1/- .3A.

SD ,0I ,13 .1')P .6 .x22 ,00s ______

cs . 1.S- S-'I s.Y. 3 V-1 3%y10 T - /,6 ,)- /,9.,W - /.?.- = 1,,) "- - -,f -I.. .

3.0 SD .0771 ,0o41 - 3.? Ac? ,o7y V."Y' a .ils

C S iS,/ ? , , # f S- . .1.2 / 2 0f , /-'.w ., P ?O6.0 T - .11 - .c'? - 1.0 r - z.lc - Y.o3 .,6 -. 1,o0

SD .oS'l ,oV ! ,1i3, .oIr .i . ICS -r6. S.1. -. I- - 6(7 o.f 3 , p1 f

11.4 T - I y?9 A. /.05. - /.I.f -/.t .1.'9 -1,9,

,o SD I .Cy , ,0y' .6 , -063o

CS 0 1.>6 ? >. . 0I 1

...... 8 1- 1., - - I ut' - - 1.0- - .Is - ,1 "r

SD=Standard Deviation 50F

Spatial Dispensing One Week One MonthBaseline-___ - _ _ _ _ _-_ _ _


Cs 3 1.4' 33. ; 3j.. , Xy.r

.5 T /. -/.. . - /.YI" - r..9 - ,4) -" /.S3 -. 3.j9 "

SD ,OIL-_, _____,___ ,6. ,o14 ._ 41_ _ ,_ _

CS I , , M- .c. (qg, f...k3 . I.

3.0 T - ,iZL - ,;,, ,;,7& - ;,C - 4?2L -_a,13.) -j.r9 _,

__ _ _ _ _ SD ______ ,0A- .035 ,0 .1/ .09 .137O9cs ,3'.I- /5C',-' rr L/ /y, 7 '3.j 3 "7. i '.q

62.0 T - /,'/ ?-- -,.,.) I.-J' -I. - /.?? - .f - /,1.'i ,'

SD /Ys___ ,o___ .sy- .0, .0s- ,0as-,

CS 13 , qIts , 13t, -7 ;, IY.-

3 T - - - 1.3, - /, - - - I.r,.sSD 7. ,o'l .0.3

CS Ho ly.'. 33. .2,2 12.8 T - /02". - - /.9? -/.,2. ,.o2 - -

SD ~ ,07f ,og ,oI1" ,o .ICl' ,o't( .o___

S3.0

ItS ,0'? ,_____ ,I?-V ,07'. ,. ,____ .ctj

6.0 T - -.y ,.io- *.a#') -t lf - qtI- - .r' - 0 , a

11.4 T _ _ -. " .1,/.' _ , j __1__ "_ .O¢- lIP?

CS 0.t, ,P? 0V q. 33 , .1) 1 eAq-7

i j . - ~ac - .-j ;,j: i .- i;s _ ,.-.A. .n., SD '.0 CiJ91 .033..? ,072 .cl X

CS9. 11;

r .. ........ -.... .... a ......... ®__________________________T=Contrast ThresholdSD=Standard Deviation 50G

_ _ RIGHT EYE



CS . ,.? .,. / 43.? .z /733.

SD o___y *C)?9 *iqi _____ , cS' - ,C27 __013

(21 40 0.1.0 - 7lr - - . -

SD ,07Y , ? 0qo7 C62 ,_ _ __ i__ _7A_

3 .0 T - : . ; . - I , , - , - 1 . - S - J . A

SD & 97___ , x A. .,'0 3 .

cs /" t~., /00,4 IP .I I # 1 IA. 1 7. I fy~ S_6.0 T - 4..c4- - . - -- . - ,,,l - l.1

SD ,03o 0 1 ,o' .06 ,0?3 .011

CS . ,. 1o,.." '9..Y I ,( 0 /,to,9

11.4 T - a.ZS /. r_ -- .' - - g.,-SD ,0., ,o', 1 , I1? .,. .06L

22 8 CS L '1 . 3 3S.7:..r-Y22.8 T - - . - J.,-3 .?1 - i..?

SD 0z1 ,_o___ .oal I I . 4 __,o, ,0;4

LEFT EYE

CS V. :1/ ,'1.3 1.7 ,o,X .

SD .0, .I,/ ,06- .o - " ,or9 ,Io

1.0 T - i.:1, - I. - /.?' a - . -I.,l - ,.4?,. -ir,

_____ SD ,03 ,o : f .oCl ,oS .o/,I .o17 .0'ICS I."1,? 13y.I i.t's -It ,11.3 1'3.'? ,L'.

3.0 -

T - .1/ - ca.IZ? - .1,11 -. /.5 ,,.:, -. 21 - 1SD ,/)1 ,0S . .1 , a ,o ,o - , o4

30 CS Jr 13Y. 1 11 0 H*..( is 3 11/.3 _/3. /1o

6.0 T - J.I -,g1 - 1041-3 -,I-,o-. - .OIL

SD ,ox .A - ,c6 ,v ,;a? ,o ,7 NZCS /00.4 7.4 14 y',h io1. '".?;,

11.4 T - ,ooT - 7- i ..r -/.1f.; -. - /I)S- - 1. lr

.o ~ ~ .3 ,0y :q ,g- , ,q . 070., ; q S_ w

/ - .ff - I.',, - - - -.di.l .o . ,..

T=Contrast ThresholdSD=Standard Deviation 50H

RIGHT EYE

Spatial Dispensing One Week One MonthBaseline- _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

0 Frequency CL Removed CL Removed CL Removed

CS j1.. I. s, /.0

.5 T - I,/I - 1.02') -9/.i - Y -i, 9? ) - , - .

_ _ SD ,O7 ,o ,/ ,0 ,o)S .)0) ,011

CS 6.1.7 Y1 S .- yf. / .P yo1.0 T - . ?,6- ,17 170 - /.74)o. - - .- - .

SD ,rp ,0r? ,__ " ,(o2 0-IL 01, r

t 3.0 T V- - - - -. os- -

SD ,___s_ ,, , ,ost.0, ooI 0I

CS 7S .' 7 3k6.0 T -/-,( - - - /.i - - - /.'

SD . ,/oL ,0C 2. o ____O_

Cs ; ,*. ',)i 3./ , ? .' -T . 2 .

1 1 . 4 T _ - /a3 - - / I - / . .4 - I ,V .')

SD ,032 ,0_ - ,0i7 ,i;L ,0./I , ___,_.

CS /2- 11 o.3 12 P .06 /

22.8 T --/,Ov. - _ - /,o1- .- /Ys- - 1.o' - x07

SD l/0 .0A _____ ,A3__ .c' ,Il I

LEFT EYE

cs i1. 1/ I'/.I /' j'/73 1q. / i

T -7 -. oq - - I S-- - l.1 4S" - IS-SD .0_ 0c0C's- 1o41- .,ey .os'Y log-

1.0 ) 1 - Y - S

SD ,1(3 ,k , ,YY .O'V .OY .0

CS 3 R I 13/.3 1.1 )63 1W.1 V.a3.0

SD ,_____ .c$) .___- ,I'/2 , o''1? .09 ._o_ .

CS 9t / Y3. 93.) S I.- /0%1 o r6.0 T - 1,'8 - /. 61 - ,2.0" l.X.% - .01 o - ,I I

_ _ SD ,o71 ^7 ,ox .oS&' ,//S ,013_ 0.f-

CS 33.1 j I L 4o4. _ . 30 7D.0-11.4 T - /.-0 - /.7 -/0-_f - /.' _,J - IV

SD 07 .03 _ _s__, _ ,o U o03 .1RON

CS I7,0- 30 .1 ,If.; .1 .- 71 gi. T It,;::8 - .a 1f' . f #- /.,.t - 1..s - .// L - /. yj - /. A. &a

, tr .,/e . =-. .o, o .0%A .OU

T=Contrast ThresholdSD=Standard Deviation 501

RIGHT EYE



CS ,S3 /f /..5 s I-a Z / A - /- 07 /40,Y /.

SD ,O' ,Oi' O.- ,,3S ,. - .olot

cs z'/ '-/S- 3 A,-S- q, a 30.'" qo. 3T -/, /.6L - /,. - /. - / - ,.O- - /,"

SD ,0'0 ')O - ,O ,oSS ,Oqg ,O ,O___

CS 1?. 13g.' k/. A'?.'6 f3.0 T -/..'/ -, .I93 - , - - . _ ' _ -

SD - , o0/3 02 .0'Y' ,/o,093

CS ,,,- /'? y s / 3.r s y.:6.0 T -/,?Y - . - /i2/ 2.03? /,3 - -

SD 0O;X 9O ,O-,' ,0.2 ,OY2- ory ,O_ _

CS , .8 . '/I. y s.1 -11.4 T _ 1, '.9 /,2W - - p.?Iz- -, 1? - . -

SD - /0,o-yr ,007[ ,oY .o.lCS ),. . ,r /ST- . , ..Z /x 19 /1.Y

22.8 T ./,IO_ -a - /,313 - /. . - ,.a'- -,'IOa..-

SD 0____ ,0')- Oql .03 4, ______ .01

LEFT EYEc s .23. / s a '/ . , - .1L? l

.5 T - i. ' - i.,,- - /7.J9 - i,o~R - t..r " - 1./75- - /,O0,SD ,°o °R/ ,0/ ,_____ ,0%( ,0 .fl ,OYr _____ "

___ __ __ SD __ )_ .o91 IM__ .0 owq *o --C S ,0. Y .38.3 3 .$ " (.O

3.0 T -613 - I~ - I l - I - i ') - i. -

.. _SD , '(o-o ,07rg .o6Y .0C / .oS

Cs I , 1 Zo , /% 01 1? ff, '. q. y3.0

6.0 ST - q- - 0- o - Oct - .y - o.r"

11.4 T - I s € - /.'?t -$.o- - I,?*PJ - .*? -,..," -_ _ SD .061 .y, , Y. : .0, ,31

CS 3o, r Sy. . L .ra.( 'a.- 33-,S- ,29.3

11.T /. /,)/P /. 7 /. P/ -,9 /. /,, r _ i l _ . -.- / .,1

CSy .... /9-. :go, 5'._ I / i- - - . '-- - I - l.Y6C --- /,

~~~~.00 1 ,o-/ ,1a ot o. .0oy .y

T=Contrast ThresholdSD=Standard Deviation 50J

RIGHT EYE

Spatial Baeie Dispensing One Week One MonthBaselin -_ _ _ ___ _ _ _


Cs 3J. 3l. .1/X uo.f 3-4~ '/2_.5 T - .f/ - - l,.1- - I, Vi - .c - , -_,

SD ,VY1? 013 .101 C)14_ *o'r s-

1.0 T I, 7 - .Y - . - :.C"- . - 1.1

SD ,A ,o ) ,o12 ,q.j *C ,Vtf IL3

CS / ,I /q2.? I L'.j , /%.' id /

3.0 T , -13 -- - 2.1' -.l . - 2.136 _ .-_ 1''W - ./9

SD .0l__ ,09R( ,o37 .6__ 1.0 .011 lot .D"4.CS ,/,, g 111,% ' ~.I &)] I;1' /C 1 ii.. ,,1 138..

6.0 T .1 - J..1 - , I3 - ., - -_ 1.O- - g.H3

SD o1 011 .0). '17 ott47 __a?_

CS 11y.. o'j. io... 0 l /o 16q.5 o, Io7

11.4 T 42,S0y - ,O1 - o - ,c - . - /.? - jO.7

SD 1.ol ,1/. ,oCas 103;L ,osC .031

CS 71.f '/7T y. It. Sr k-22.8 T - I.-,g7 - /1.6 0 / - 4 L - /. Y4 / 6 - .--i, ytf - ,9 q f"

SD ,0 .133 ,OP3 , Ck- .062 .Oq3 .7'i

LEFT EYE

CS 32. ' .1 .2/xr 'I3... 3/. 3 1. 1 3_.5 T -/.' - 7 6 2 - ..- - -

SD ,OW_-_q ,0 1 .o3., ,o .4?_ .0.-1 I/

3.0 T ap _1.0 T - I/ -/ y - 1.;z - ig. - .,.oLz - I,°i -. gS D , _. " , ,, _ ,_ ,,_ . _ _._ _ _ _ ,O 3 ,g0 1 -

CS I .f /a. I. 1 i/7.5 ix.s' j /6.s /Y.16.0 T - ..II1 - . s-.? - .,07.. -xOi , 1./Y0

SD ,of ,o0 113 ,oU 0 , _____. _CS III. i IlIX 17.3,Y 12S-, x 1 ', /41 ..s- 1.sr.

6.4 T - .3. - 1W .A - - ,.7 --. ?,CIS -. 1--

SD .07 ,oy .o Io P, ,o3 ,or-

t'' - .I P /.I o-, 3 -- -. )].7 I11.4 T /. 7- - /. fr fix. -/. /. T - I.t -w.q

1416. o1 OX-¢ ,€ .1 ,if,/ la .o JZ .r

tl ;,v,8 i.& £ - i. rp _- &l - .1--., -17] .

owl' .06.r .0A( ,,0.4S" o1 ,o44

ThContrast ThresholdSfr=Standard Devittlon .K

Spatial Dispensing One Week One MonthBaselinE - -_ ___ _____ ____

*Frequency Cil Removed CLI Removed CL Removed

CS /X. 3C,.S

.5 T -A 1 /.SJ S1 - /. -. 7 - -1

SD /iof .11 .0IJ '~07 .103. ,IrL'

1.0 T - S_ 0 3s - 0.9/S - j.81 - - ro /'4 1~

SD O3 C"Yf (07 1 O9 .047 ((1.

CS 11j'. T4~~' iiq ,o .c3.0 T - .. oS4 /) ' -1 JC/

SD DST_ ____ io ____ _ _ ,Cryf w

CS 63's- /Y91 Y( S) 12C)( s;2S 13/.' S'Y. 36.0 T - .?oL /7; -/;2L - .2Y -Xli

SD .08 101 0C69 ,V6L V1 / 1oj' .103

SD 10Z1 _____ IOi' IODI __0__ ,O07Y*~

22.8 T -/,:33 - - Y;? ?.1 - /.V''S - - .V

SD 'or?_ .1?!' OWe .017. ,s 1/7 .034

_________ _______LEFT EYE -_ _ _

CSY.1 2 31 g'. I qy.s YSr7.5 T KY -- /. Sor -1.02? -,s*7 -' - /6

SDIL ItS .u? ___ __ .06( 04;L. .0'?

T 1.0' .7 -20 /.2 3 - /.h'/.F- /.& - Y_ _ _ _ _ SD __01 _ ___ __ , oq 101P- _____ .0_____.

30 Cs 2. /5,ror /II. ' /07 131-L Y6 I.. X-i&.30 T - .;-17 ~.Y - a'Yr 1s- Sj~--

______SD -of4 'O? 1Z *OM' 103 ____S_

6.0 T -J0j -. Af-1 -- .to.1 -? ,,:,r

6SD .OV/ '09 '1 Al ao,. __ or

114 T b -I' JJ - 0.13 -ii? /.S /, TP b0

SD .03 .L 1/64 ,OIL loi' o Ty

.ot j .ar .~ .03 C

T=Contrast ThreshioldSD=Standard Deviation 50L

________ R~~~~~-IGHT__EYE. ________ __________


pFrequency CL Removed CL Removed CL Removed

CS 4 ; . s.Y g . ?'?

.5 T Y Y3 / S Y2 - /*cjQ; - /.Vo r -/. YY& - /.rs

*P CS Po.M 4 Lsf37

1.0 -- /.?IscVf -- - , gs-sSD ofl 104___ '061 A103 O5

CS x. -V3 j1S7S !.* 3.0 T -. li, I 6 .% -.. f .

SD '03 _____ ost 0;7 .051 I~ *oCS I141( '. . 6333. 7.f

6.0 T - .C ao-/ .R~ -

SD ' ,o7 ,O?r __04Y

CS S'01 -- '1 7S S )- q,2 1 111.4 T 0 /.?L - /.L/ - 63- /.4?

SD .07;- __ __0*o4j ,1s~CS Jd A) .0. 14 /

22.8 T -J.'j'2.3p- - /.34 - 1.37~.- /As.F- /. 7-Z- -/1

SD '06 ______4 '0->1 '(0z' ."_ _ _ _ _ _ _

___________ _______LEFT EYE _ _ _____

cs 34.1 3U~a

T r - ->; y.7 - -

SD .0141 ___ __ lot 0_______ . 103___ _

Cs 44-1 9-.' Y" gy1.0 P- I ir .~.-,~T

- /.7L -jw

_ _ _ _ _ SD . pr, 1/ .06j- *qr- ,oz- *. rl _____

CS ILL. 1'/03 //L A 47.S f I/01.S3.0 20T~~~~~2 13 s.* - J-OaW - *.1z.- tD6- 2OI

SD____ _____ _____ osr I ?0701 .03') *O04___

CS ysf ioO. cil 9S r?. L 7Yi6.0 T -062 ).c~ - -T?? - ts - ?.PP bf

_____ SD ____ .03T *06v .03LZ .00 .033 .12.

CS S3.SSQ? 1N.L 3-gr- q2' L Ii114 T -01 1y? '-I* - 0 - bli - 1.41s- bt

____ SD .08 i *043 O' .101 or? .~

G,; 1 Sa q.J31.1 /? .

.oI~ 0q 9Ot ./I .0A&

T=Contrast Threshold* SD=Standard Deviation 50M_______________ ___ fIGHT EYE 5OM_ ________

Spatial Dispensing One Week One MonthBaseline-_ _ _ _ -_ ___ _ _ _ _ _ _ _ _

, Frequency CL Removed C1, Removed CL Removedi

CS I /7. , G, s- 1 / Y.1R 0Y.

.5 T /,- g,2.L -/.4twz - j, 'i'h- - 1. q 1 - ?- - /;

SD .0__ ____ O'' .0-54- .03, 04 *0o~s

* CS 7*37 q~ 2.3.'?1.0 T - " / - /.A I- " ' 1- "" - /."tS - /70? t- "'

SD .ooLlCS /J/./092- i Z i I t

3.0 T .,7 - H -

SD j_____ 04___ ___ _ t1 ____ *C5

Csia L i(. Jo 1 I i&'' 7),

.- - ' f II .,- . ,- . .o(1- 11J. .? - V.oY

SD "C "os, I log'( " 0'

11.4 T /- 9 - / s -So - .' I- -1 /.,,z i

SD ,OS , ,,,... .. . . , . . . . . .. .04

228 CS .3 4 ~ ;1L, 5, 30 t .S- .

228T -/7)1 - /, I eS 1.i Z. - j14) -,1 1 _t

SD 107( v lo'j( ,I7 ' 0 ,O3 ,3?

_________ ____ _______LEFT EYE_ _ _ _

CS ./ 2 4'.5 T 1j2) .31 - /3Ps - 1.q.r - .s -!/.--r S-

SDL ., Z~ ,oq- Oo.l '041 .,01___

CS jq). j.j 1zz Y-. 1 .101, S*9- 'ft.?

3.0

_____ SD ______ 4 o7 X4Y ~ O7 *'S ___

CS I ILL ~ I~. I iur.ax C13 loa, 11.9-6.0 T 2 of- .")L I.4 -,OL /

_______ SD .0i S1 o' ,OTT -Ort ,oL/ .03

11.4 T -j.?A~- 67 -- j)) -J)3

____SD _ .2] 'ls loss- lo 00ctt .01i3

C"; I. RS '.A 1.3 .1 ,u? /3

* .'28 -1r /~? ~ /S - I.'i ma& .3

T=Contrast Threshold -

SD=Standard Deviation 5ON

-R I G H T E Y I _


Frequency CL Removed CL, Removed CL Removed

cs Z- L z.7 3). C.

.5 T - /,Og - . - - lS . /.log - 6c"

SD .0C? ,oi ,') I

1.0 T ,/, 4 - / ' - - /.,s*- - I , -

SD ,__ ___ ___ ___ ___ ___ ,OLf ,___ .____ _ ,. 3CS / I-q,, I*Y . l -,3.,

3.0 T - - - . - - 1.7 - )J4 - j I -

SD ,o'4j ,,o c4f .o'? , f ,

6.0 CS /Q.- )L t- C 1. /te( ,19y, /Sl.J

T - J.. - .i 4- - F- - - -

SD ,- ,-.oy *oO J 03 ,o31

CS 10',, I. . ,o, )7 .11.4 T w1 - - - - .') - I,?Frs - /.d' -/JYp2

SD ,,CL0 ,oDs , ,oi ,o_ -'_

CS 13, L/43-22.8 T , . /, I ') - - /oI - -

SD .oqs-" ,0 1 .0'? L .

LEFT EYE

CS '. I--I

T -- 0 - - - - --. ] -

SD ,,__ .j ;I2 .017 ((3 ,0 0_1__

4.1.0 T - /,I" .)- ,1 -/,.)'> ,¢ &" - ,9- /.?______ SD ,o7{ ,o. ,____ _______~ ,1W

r .O____ ,O___

CS /*6, 0>12 13 .r- ISI-,/ J IOS - /30.33.0 T - / . Y ?) - -.1 9 ,, . , V - 1 . 1l'

SD O___. , _ ,o-0;0 1/ 3_I,, .

CS 13P .2 Y. Iz , ."Iz, 1 , 3 ,13t6.0 T - Y - 2 - 1,7- - I/S - a- - /

SD ,Ol_ _ ,tOfl ,031) 3- ,061 00f

CS 0'. ff)t, ,/ 3, 3?,b0 O,. S-3.y

11.4 1P - 1 ,' . / - /?o - i,?Y2 - /.' - .04- - /,o) , / ,o0%f . , .,

CS .1 ,o /3.6 g . - I,. - . I

,oI? ,o? o f1 Aoy , $ .Cly ,17

T=Contrast Threshold* SD=Standard Deviation 500

RIGIIT EYE _______,_______

Spatial Dispensing One Week One Month

I Frequency CL Removed Cl Removed CL Removed

CS (77. 13.

SD 15-3 .CL 0 o Cr I CAS__ ( _f__ A

*C s /? . / .(' / ', 1 3 /o : s- q q

1.0 T -/. S - - / .37 - /. i -/ -. -

SD ,-, ! ____ ,e" ,o011

CS la~ MAO.' )j.i

3.0 T -10 - /.7l - /?o3 - -i." -2,'

SD . 7 oi ._o_ _ ,_ _ -_ ,e'( ,C?,'(

CS 0A~C .R,. 3q.2 '?f( s6.0 T - z _ - , /. '7 L - c L-- .f -*.1 7

SD ,of ,O.W .- o.J'? .______

CS S-1.3 1. - '-/V.S/ - Sc 2s11.4 T - y./ - ib - -6)r, --. 17 - /."o'

SD .0'j7 ____.0V_1_ fly( ," .130CS 1Y,7 Y n .4 /. 1,? &'.

22.8 T - - -. - - I.2L - 1/'I '

SD .0V I ,o1r .y ,O./ .vj .

LEFT EYE

os II OAS- .3 r / ii, 'r.P

cs ,0,i- . , 1/.71.0

T - - /Y'( -1, -3S -/.-yl -C I Y6- -

SD ,Os _ .o_( , or , oP I .03_t- .Da s .o?

30 CS qr.1f 711,( oq 0d. '- 44.'[ 100,6, /0o,/

3.0

SD ,o6, 6 o_ _ ,o , .CY. 0 _ _-

CS 143 3c )$1 VO, W.2.

6.0 t - 1. ¢ - I ? - i. /. ge~ r _ ,c - .o U 1 - /

_ _ _ _ _ _ S D .o s 1 .o I .o 3 .e C: , o y z . ,__ _ _ _. o

11.4 T - - I./.S,

C S; a l.1 / 1,? /.r yIf .,-/2, py. - : o,

12.8 .T, - .O _ I 9.1 ,/ . - - r,VY Ole .oX .,2 .11, t o *

, ; ', I I

')

T=Contrast ThresholdSD=Standard Deviation50

_______ [RIGHT EYE ____ __________

Spatial Dispens~ing One Week One MonthBaseline - - - - Ii

tFrequency C. Removed Cil Removed CL Removed

CS ~4 '? .~.I 3..5 T - 0 Il /, ; 7; - -

SD __q _ __ _ __ - __ _ _ _ __ 0

CS C1 . - lZ7.- 13 /0 12.

1.0 T -t -r 2 .1 7 - 'zz

SD loq7 ____ ~ l ,9 ,oR?; .05-1

CS j s~ 'qj.i IO7 1'~

3.0 T - .7IW - 3/7 IIL-

6.0 T - 01.j' 0 - g./ to 2 7. .3. 'a aI~r

S

11.4 T /,y T7 ci - .ooa. - 0 (.P -

SD .01c3 .035 0??

22.8 T 0? -/F~ 7

SD '08.1 .02 .O0it I O Iof '___1 __ 0_

__________ _____ _______LEFT EYE _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

TS 79 3 -- . ~ S - - 7 ;

1.0

__ _ _ _ _ SD IVY__ I0Z:L I/OY' os- __ /__/ _______

CS 12.8 112-1- S,'b4 1344 1 -q( 160 10.

T .1-31') - j.L 1j - .1.9. 1.1j4 - a.g - '. /a- - ?

__ _ _ _ _ SD fogy ____ .01 oI' .11L . 02-r .1" .01

CS JY1.1 103.fr /Y0.'Y 17'f.( I ?. 1 1 .0 111.1P6.o 1j 61 *.Isr - ..oS - 1.t17 1.11 - .117 -0 Z .0r,

______SD w___ .0ts .0- C) .os-. .Ofx '*6r

CS Ta.3 96d j~ h( .6

11 .4 T -I.?Wr = v43s- Ofc4 -. 1 ?S-

';D 01 ,'.E" 0A2 000 Ole Ofy 0

GS 6'L 2- 33.3/.?~- .?~ s:iier

T=Contrast ThresholdSD=Standard Deviation 50Q

_ IGHT EYE



CS .?1,P 1, 34'1 -74 S- A7 3 q. i-

.5 T -. 337 /1c - .S - - - /.z2L - y - /r-SD .0,0 - .IZ- ,oc ? , -y .to 10x.01s- .0'>lI

1,0 q0 6-- I, o 1,1- 13.1 3- . s - 49.,'l -/

SD i. Cps ,ir - 03o ,aCS 9o sa.

3.0 T - . - - - /.1' _-.4 ) - /_",

SD Olt o034 ,0 .104 .,7-) .o1(3CS 7 ~iL/d3 5*- -

6.0 T -[.I? , - . - Z.t1L - I. '( ,

SD 04 Y *e ,o1- ,or1 ,o___

CS 6~. 0A. jo~ 1'

CS ; q. 7 77 32 3.1, "a;,.' I22.8 T -14?s .6t - . - . - J 7 -/.y - I. -: - 1 Y,

S D ,0 4 ,A I, t .~ A3 7 ,o (

LEFT EYEc s W ,. I /7y .. I,- I . t 4 1 .2 - ;1/. t ?

6.0

.5 T - j..i.2? -s - -/, ? - /. Y.Is - /..63t,-.

S D , 0 '3 ,, i3 .0 2 . Y, ,0 6 lt.F

CS 'j3.? Z2./ 3 40 ~ 3.(

SD Os7 .012. .0"J cps-___

3.0 T - 13I- - ( I, y -- / -_l. - 44

SD Olt1 ,o61 ,o'( _ o__ ,03 ,o___-

CS 7IK -L7.J /3q4 );L ~ OIL 1

6.o T

11., T - I.'f -/.7L -/*'W - . - /.'l - /.3Y -/.fl

soI ______ .or6 ,3'? ,oL ,o j ,i?' ,er"

1.0Y .7 2

CS . . P .. 4 18.9 V, y i,- V,-. Y

022.8 - . - - l.- - -l.r . - , -l..

SD=.u(& . .7 os7 off

T=Contrast Threshold.D=Standard Deviation 5CR

RIGHT EYE



CS ). 35.1 i*. 1..

•5T --- L _ /.q - - /.s.21 - - /. 7 -/,.- - / ,t "

S D , _ _ _ ,o ? 7( ,0 9 , 1 .S- . c4- o g - .o Ir

1.0 T -/.S/L. - /.77 - /29? _ ,g~. - /.S.2 -. _-.' -/.2

SD O . o,,

CS 1P. , 7I.. y .,3.0 T -of2 - 2.0 - , - - ..-. - .4 7

SD C, -. .oA 01/ -0 ,

CS -.. ( 5 . ". /co

6.0 T /.c/? --2. C?& - . . - -

SD o ( ,7 . i

CS .z -I I., ys fit 7.4

114T - /.'?,. - /,7 - /p - t,? - /.?'Tr - 1.6.. - / ?SD .()Ii~ ic csS )?r~

CS 4/- /7 ,. .,,

22.8 T _ /.-,- - ),- ) - ).03 - /.s9.S - / 27 /.'-Y.

l SD .0?) ,O___ ,1 .lI .09' ,I/ ,o s

LEFT EYE

CS .'? J- - / I A-? 7 .-3.5

T - 1. 3 -- /. s - - /.- i./ , L --/.9s- -/. .

SD , *(' , ' .I., op- ,7[, .____

1.0T - 6.I - - ...? - / - - - ,j'-, .

SD ,C_,,__ ,Pi-. I ,__ _l_l l . 0 .03

3.0 C .73 7

T - .s- 2.c.- - ,,- 1 - ,; - ,7 - / ,,

SD ,O-_ _c-_ ,c_ ,___ - 1 09 _ _1 .oAS

CS 1/,&1 /0.. 9.. 1, 1 .- //6, ? 7R

6.0 T - Y - ." - , - - - 0 /-

SD. ._._,_ .0 I.

G'S 'c ' / 0. 691 -g-. L.

11.-4 -- /.,' - /. 1 -- .,. - ,T - -

SI) ,O61 DIL.

IC-)L A 31.3 49S / .-- -/ L - 0 - / - I

.o? ,o o os ,o"'('

T=Contrast ThresholdSD=Standard Deviation RIGHT EYE 50S

Spatial Dispensing One Week One MonthBaselin - . . ... ._ -.....

Frequency CL Removed CL1 Removed CL Removed

T.5 - I 1 ..L - A - /31 I , ,'

______ SD .084 OS-3 .11'? G&'IS *C' ,c~) ./zfCS ' ' ';L q/ '4

1.0 ,.oi - I , - ' / '102 - ' ' / " j'

SD osr?. .oR, .0, c,-L ,o;'V 'c,CS 9T1 lot? /(XV ,~ 1c,7g St)

f 3.0 T - 9 Co~ c. - /' - 'U'p_

SD 070_ o~ ____ c' ,jZ ,sCS &- ", C o 0.

6.0 T onE

S D 0o _____z~ O - Cye' 0'__

114 CS ~ L 3c'q.? '& 5~L114 T &IT- j.

SD '1000 ,ol , I ' I - ,c' I C4 1 ,131

S2.. t IC S /' Iay M23,L d 3.2.8 "T I- /7 - /, /.2S -/.3j I -/,JF I- -

SD .o I .o .o, Al .'?

____ ~~LEFT EYE ____ ___

CS.I I I . - ' - - - )

SD -J " I /U -.0/ - - / ,s" I- i. 2 II -ty7 I-/.'

CS 407 .711 S- i J 171.0

T : - -°43 II - : ° -- -1 '.%L I 1 N9*I -'- --

__ __ __ _ SD 'lo ___ __ ___ ,Q' LXw

30 CS V0.49 Fy.( / P /.(3.0 T I 1r /, ?;,r - /7?-CIP -J.?y

£SD .Ote ' Ol ,c .o1 .0ss2 Cc O'),P

6.0 T /. .~~ OR .l I e- 0 ' - 7,vy -

_______ f) 0~ 0 Oct' _ Cg Cis 0? ,

.... ° - I '° l t'i '0 1 ° I '° ' . °

.O e .o I .0'f4 107rI lots) Oii-

51

APPENDIX K

DEFINITIONS OF TERMS I

51A

contrast sensitivity - the logarithm of the reciprocal contrast threshold.

contrast sensitivity function - the curve generated by plotting contrastsensitivity against spatial frequency on a log-log scale. It isobtained by measuring the sensitivity for the discrimination of asine-wave grating from an homogeneous field at each of several spdlialfrequencies.

contrast threshold - the difference between maximum and minimum gratingluminance divided by the sum of the maximum and minimum luminance whenthe grating is barely visible.

contrast threshold = Lmax - LminLmax + Lmin

spatial frequency - the number of light-and-dark bar pairs per degree ofvisual angle subtended. Usually referred to in cycles/degree.

i

DISTRI1SUTION STATEMENT · 2011-05-14 · contrast sensitivity function (CSF) and soft contact lens wear. Contrast sensitivity was measured at six spatial frequencies for nineteen

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