Abstract
Reading is a primary problem for low vision patients and a common functional endpoint for eye disease. However, there is limited agreement on reading assessment methods for clinical outcomes. Many clinical reading tests lack standardized materials for repeated testing and cannot be self-administered, which limit their use for vision rehabilitation monitoring and remote assessment. We compared three different reading assessment methods to address these limitations. Normally sighted participants (N = 12) completed MNREAD, and two forced-choice reading tests at multiple font sizes in counterbalanced order. In a word identification task, participants indicated whether 5-letter pentagrams, syntactically matched to English, were words or non-words. In a true/false reading task, participants indicated whether four-word sentences presented in RSVP were logically true or false. The reading speed vs. print size data from each experiment were fit by an exponential function with parameters for reading acuity, critical print size and maximum reading speed. In all cases, reading speed increased quickly as an exponential function of text size. Reading speed and critical print size significantly differed across tasks, but not reading acuity. Reading speeds were faster for word/non-word and true/false reading tasks, consistent with the elimination of eye movement load in RSVP but required larger text sizes to achieve those faster reading speeds. These different reading tasks quantify distinct aspects of reading behavior and the preferred assessment method may depend on the goal of intervention. Reading performance is an important clinical endpoint and a key quality of life indicator, however, differences across methods complicate direct comparisons across studies.
Highlights
Reading is a complex visuo-cognitive process that can be negatively affected by vision loss
For the true/false and word/non-word tasks, threshold stimulus durations were converted to reading speed in words per minute
Representative reading speed data for each task from the pilot study are shown for one observer (Figure 3) in black for MNREAD, blue for true/false and red for word/non-word
Summary
Reading is a complex visuo-cognitive process that can be negatively affected by vision loss. Reading difficulty is a primary complaint for low vision patients, and improving reading ability is a major component of vision rehabilitation (Elliott et al, 1997; Stelmack et al, 2017). Reading performance is a key vision-related quality of life indicator, with lower scores on quality of life (MacDQoL questionnaire) being associated with visual impairment severity (Mitchell et al, 2008). Decreased visual function is associated with increased depressive symptoms, and significantly impairs performance on activities of daily living including mobility tasks, preparing meals and taking prescription medicines (Binns et al, 2012). Reading behavior encapsulates multiple aspects of visual, phonological and semantic. Reading Performance Estimates processing and requires efficient integration of these processes. Vision loss can impair reading performance at one or more of these processes
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