Abstract
ABSTRACT Clinical relevance While the clinical focus of performance metrics is traditionally based on visual acuity, research from the field of visual impairment has demonstrated that metrics such as reading speed and critical print size correlate much more strongly with subjective patient reported outcomes and assessed ability in real‐world tasks. Background More recently, digital device use has increasingly replaced many paper‐based tasks. Therefore, this study aimed to assess the correlation between standard acuity/contrast metrics and functional reading ability compared to real‐world performance on an iPad‐based reading task with astigmatic patients corrected wearing toric and mean spherical equivalent contact lenses. Methods Thirty‐four adult participants, with −0.75 to −1.50-D of refractive astigmatism, were enrolled in a double‐masked cross‐over study and fitted with toric and spherical equivalent contact lenses, in random order. A digital application was developed to assess zoom, contrast modifications, the distance at which the tablet was held, blink rate, and time to complete the reading task. High and low contrast near logMAR visual acuity were measured along with reading performance (critical print size and optimal reading speed). Results The amount participants chose to increase tablet font size (zoom) was correlated with their high‐contrast visual acuity with toric correction (r = 0.434, p = 0.010). With best sphere correction, zoom was associated with reading speed (r = −0.450, p = 0.008) and working distance (r = 0.522, p = 0.002). Text zoom was also associated with horizontal (toric: r = 0.898, p < 0.001; sphere: r = 0.880, p < 0.001) and vertical scrolling (toric: r = 0.857, p < 0.001; sphere: r = 0.846, p < 0.001). There was a significant negative association between the selection of text contrast and zoom (toric: r = −0.417, p = 0.0141; sphere: r = −0.385, p = 0.025). Conclusion Real‐world task performance allows more robust assessment of visual function than standard visual metrics alone. Digital technology offers the opportunity to better understand the impact of different vision correction options on real‐world task performance.
Highlights
The distance adopted for reading the webpage was inversely related to reading speed (r = −0.343, p = 0.047, data not shown). This study assessed both standard, clinical visual metrics, and real-world performance of a common digital task and how this was impacted by visual correction
The tasks were relatively short in duration, but the print size in the website varied from Arial 9–18 point font, the visual acuity demand was over a wide range
The findings suggest that even the simple task of holding the digital screen at the preferred distance, and pinching the screen to optimise the task magnification provides useful additional information about the visual quality achieved by a visual correction
Summary
Clinical relevance: While the clinical focus of performance metrics is traditionally based on visual acuity, research from the field of visual impairment has demonstrated that metrics such as reading speed and critical print size correlate much more strongly with subjective patient reported outcomes and assessed ability in real-world tasks. This study aimed to assess the correlation between standard acuity/contrast metrics and functional reading ability compared to real-world performance on an iPad-based reading task with astigmatic patients corrected wearing toric and mean spherical equivalent contact lenses. Results: The amount participants chose to increase tablet font size (zoom) was correlated with their high-contrast visual acuity with toric correction (r = 0.434, p = 0.010). Digital technology offers the ability to present visual stimuli in a more controlled form and can use on-board sensors to assess real-world elements of task performance such as working distance and screen changes. The time to complete the task are recorded
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