Visual acuity: Perceiving fractal objects in the presence of macular blindness

Macular blindness is a tragic ailment that renders a person’s eyesight virtually ineffective. Those who suffer from this malady are painfully aware of the duality of their affliction. They are functionally blind, but constantly bombarded by fleeting, nondescript images that are more recognizable the less detail they contain. The condition is exacerbated when corrective lenses were required before the onset of macular degeneration. This report discusses the impact macular blindness has on visual acuity in general and specifically the predicament of those who must also cope with corrective lens inadequacies. Some of the concepts proposed herein are hypothetical in nature and have not been confirmed by investigative means. However, the writer is obligated to document, with utmost objectivity, personal observations made while living with macular blindness in the hopes that they may contribute to current scientific research. Much of the material presented derives from personal experience and informal discussions with patients who also suffer from macular blindness. Evaluating visual acuity is necessary when corrective lenses are required for proper eyesight. In a simple eye test, it is proposed that how well a patient discerns test targets on an eye chart is actually the synergy of two distinct biological processes. The first is the ability of the visual organ, the eye, to resolve detail and shall hereafter be designated Process 0. This is the foundation concept of visual acuity. The second is the patient’s perceptual cognition of the acquired image as a process of higher brain function and shall hereafter be designated Process 1. Because of the negative impact macular tissue damage has on Process 0, determining visual acuity becomes practically impossible. Pathology of this nature, however, does not extend to Process 1. Normal everyday activity based on sight relies a great deal on macular, or central, vision. Macular blindness often equates to a loss of image resolution and one might deduce that macular vision, in and of itself, delineates the phenomenon of visual acuity. Strictly speaking, this is quite correct and, for reasons of expediency, current medical practices preclude the need for extensive evaluation of visual acuity when macular vision has been compromised. Having said this, we begin an