Factors Affecting Contrast Sensitivity in Intermittent Exotropia

Purpose: To determine whether contrast sensitivity (CS) can represent photophobia in intermittent exotropia (IXT) by comparingthe CS test with and without glare stimulus, and to analyze the factors of IXT affecting CS. Methods: We retrospectively reviewed the medical records of 107 patients with basic-type IXT. We compared CS undermesopic and photopic conditions, with and without glare. We compared the difference in CS before and after glare (ΔCS) betweenmesopic and photopic conditions, and compared CS with glare between patients with and without photophobia. Thecorrelations between the clinical features of IXT and CS were analyzed. Results: There was no significant reduction in CS at all spatial frequencies by glare stimulus. ΔCS was greater at high spatialfrequencies under photopic conditions than under mesopic conditions. The group with subjective photophobia showed lowerCS at 10.2 cpd under mesopic conditions with glare. CS showed a negative correlation with stereopsis under both mesopicand photopic conditions, and a positive correlation with fusional ability at low and intermediate spatial frequencies undermesopic conditions. ΔCS was smaller at intermediate spatial frequencies with better fusional ability, greater at high spatialfrequencies with photophobia, and greater at intermediate spatial frequencies with a higher frequency of exotropia. Conclusions: The CS test could not represent photophobia in IXT. However, CS tended to decrease with glare stimulus, andCS under mesopic conditions with glare was worse when accompanied by photophobia. Moreover, a poorer degree of stereopsiswas associated with lower CS, and better fusional ability was associated with higher CS under mesopic conditions. Therefore, the CS test can be considered helpful in evaluating sensory function in IXT.