The Effect of Induced Intraocular Stray Light on Recognition Thresholds for Pseudo-High-Pass Filtered Letters

Nilpa Shah, Steven C Dakin, Pádraig J Mulholland, Kalina Racheva, Juliane Matlach, Roger S Anderson

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)
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Purpose: The Moorfields Acuity Chart (MAC)—comprising pseudo-high-pass filtered “vanishing optotype” (VO) letters—is more sensitive to functional visual loss in age-related macular degeneration (AMD) compared to conventional letter charts. It is currently unknown the degree to which MAC acuity is affected by optical factors such as cataract. This is important to know when determining whether an individual's vision loss owes more to neural or optical factors. Here we estimate recognition acuity for VOs and conventional letters with simulated lens aging, achieved using different levels of induced intraocular light scatter.

Methods: Recognition thresholds were determined for two experienced and one naive participant with conventional and VO letters. Stimuli were presented either foveally or at 10 degrees in the horizontal temporal retina, under varying degrees of intraocular light scatter induced by white resin opacity-containing filters (WOFs grades 1 to 5).

Results: Foveal acuity only became significantly different from baseline (no filter) for WOF grade 5 with conventional letters and WOF grades 4 and 5 with VOs. In the periphery, no statistical difference was found for any stray-light level for both conventional and VOs.

Conclusions: Recognition acuity measured with conventional and VOs is robust to the effects of simulated lens opacification, and thus its higher sensitivity to neural damage should not simultaneously be confounded by such optical factors.

Translational Relevance: The MAC may be better able to differentiate between neural and optical deficits of visual performance, making it more suitable for the assessment of patients with AMD, who may display both types of functional visual loss.
Original languageEnglish
Article number4
Pages (from-to)1-8
Number of pages8
JournalTranslational Vision Science & Technology
Issue number5
Publication statusPublished (in print/issue) - 5 May 2022

Bibliographical note

Funding Information:
Supported by a Fight for Sight studentship (grant 1973) and the Moorfields Eye Charity (grant GR000159).

Publisher Copyright:
© 2022 The Authors.


  • Humans
  • Visual Acuity
  • Vision Disorders
  • Macular Degeneration - diagnosis
  • Retina
  • Fovea Centralis
  • stray light
  • cataract
  • high-pass filtered lettervanishing optotypes
  • macular degeneration


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