The effects of photon noise, aliasing, wavefront chromaticity and scintillation on the point spread function (PSF) contrast achievable with ground based adaptive optics (AO) are evaluated for different wavefront sensing schemes. I show that a wavefront sensor (WFS) based upon the Zernike phase contrast technique offers the best sensitivity to photon noise at all spatial frequencies, while the Shack-Hartmann WFS is significantly less sensitive. In AO systems performing wavefront sensing in the visible and scientific imaging in the near-IR, the PSF contrast limit is set by the scintillation chromaticity induced by Fresnel propagation through the atmosphere. On a 8m telescope, the PSF contrast is then limited to 1e-4 to 1e-5 in the central arcsecond. Wavefront sensing and scientific imaging should therefore be done at the same wavelength, in which case, on bright sources, PSF contrasts between 1e-6 and 1e-7 can be achieved within 1 arcsecond on a 8m telescope in optical/near-IR. The impact of atmospheric turbulence parameters (seeing, wind speed, turbulence profile) on the PSF contrast is quantified. I show that a focal plane wavefront sensing scheme offers unique advantages, and I discuss how to implement it. Coronagraphic options are also briefly discussed.