Measurement of visual acuity for letters of different contrasts has been suggested as a clinical way to evaluate contrast sensitivity in patients with vision abnormalities. If variable-contrast letter acuity provides information similar to the contrast sensitivity function (CSF), then comparable effects should be seen in stimulus manipulations which simulate decreased vision. Using both our own and published data, we compared the effects of diffusive blur, dioptric blur, and eccentric viewing on contrast sensitivity for letter and grating targets. A diffuser placed close to the eye reduces contrast sensitivity fairly evenly across all spatial frequencies, with similar results for letters and gratings. However, dioptric blur reduces sensitivity substantially more to letters than to comparably fine gratings. Eccentric viewing also produces a larger sensitivity loss for letters than for gratings. Because some stimulus manipulations produce dissimilar changes in contrast sensitivity for letters and gratings, it is questionable whether the results of one measure can be used to draw inferences about the other. It is proposed that local or relative phase discrimination has an important role in explaining the different responses to letter and grating targets.