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Lots of PDFs are raster images to start with!
I open in GIMP, which can resize on loading, export with reversed layers as mpg (motion png). Then I edited the local ImageMagick security to allow PDF creation. It can crop, adjust brightness / contrast, mono reduced bit depth etc. So old yellow scans load fast.
Beware of L & R margins differing.
Obviously a recent technical article originating electronically edit rather than a scan will allow sensible editing and TOC. You need to create an OCR layer to have a TOC on a PDF originating as a scan with no TOC.
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