Maximum Reading Speed Research Articles

A new sentence generator providing material for maximum reading speed measurement.

A new method is proposed to generate text material for assessing maximum reading speed of adult readers. The described procedure allows one to generate a vast number of equivalent short sentences. These sentences can be displayed for different durations in order to determine the reader's maximum speed using a psychophysical threshold algorithm. Each sentence is built so that it is either true or false according to common knowledge. The actual reading is verified by asking the reader to determine the truth value of each sentence. We based our design on the generator described by Crossland et al. and upgraded it. The new generator handles concepts distributed in an ontology, which allows an easy determination of the sentences' truth value and control of lexical and psycholinguistic parameters. In this way many equivalent sentence can be generated and displayed to perform the measurement. Maximum reading speed scores obtained with pseudo-randomly chosen sentences from the generator were strongly correlated with maximum reading speed scores obtained with traditional MNREAD sentences (r = .836). Furthermore, the large number of sentences that can be generated makes it possible to perform repeated measurements, since the possibility of a reader learning individual sentences is eliminated. Researchers interested in within-reader performance variability could use the proposed method for this purpose.

Reading Training with Threshold Stimuli in People with Central Vision Loss

To evaluate the effectiveness of a perceptual learning technique for improving reading performance of patients with central vision loss and to explore whether this learning generalizes to other visual functions. Ten patients with central vision loss were trained binocularly, in four consecutive sessions, with serially presented words printed at each patient's reading acuity limit. Patients read 10 blocks of 100 words in each session. They were encouraged to read the whole word and were discouraged to read letter by letter. Assessment sessions before and after training measured fixation stability, monocular and binocular visual acuity, as well as reading acuity, critical print size, and maximum reading speed with continuous text. Another six patients with central vision loss were included in a test-retest control group and were tested twice, 1 week apart, with no intervention. The average time required to read a block of trials decreased significantly with each training session. After training, continuous text reading improved in terms of reading acuity (p = 0.017) and maximum reading speed (p = 0.01), but critical print size did not change. Binocular acuity improved significantly from an average of 0.54 logMAR before training to 0.44 logMAR after training. Binocular ratio (better eye acuity/binocular acuity) increased from an average of 1.0 before training to 1.17 after training. There was a 62% improvement in fixation stability in the better eye and 58% in the worse eye. There were no changes in the outcome measures for the test-retest control group. The technique described in this article can be used for vision rehabilitation of patients with central vision loss. When training is done with size threshold stimuli, learning generalizes to visual acuity, continuous text reading, and fixation stability.

Reliability of a standardized test in Swedish for evaluation of reading performance in healthy eyes. Interchart and test–retest analyses

The purpose of our study was to establish a practical and quick test for assessing reading performance and to statistically analyse interchart and test-retest reliability of a new standardized Swedish reading chart system consisting of three charts constructed according to the principles available in the literature. Twenty-four subjects with healthy eyes, mean age 65±10years, were tested binocularly and the reading performance evaluated as reading acuity, critical print size and maximum reading speed. The test charts all consist of 12 short text sentences with a print size ranging from 0.9 to -0.2logMAR in approximate steps of 0.1logMAR. Two testing sessions, in two different groups (C1 and C2), were under strict control of luminance and lighting environment. Reading performance tests with chart T1, T2 and T3 were used for evaluation of interchart reliability and test data from a second session 1month or more apart for the test-retest analysis. The testing of reading performance in adult observers with short sentences of continuous text was quick and practical. The agreement between the tests obtained with the three different test charts was high both within the same test session and at retest. This new Swedish variant of a standardized reading system based on short sentences and logarithmic progression of print size provides reliable measurements of reading performance and preliminary norms in an age group around 65years. The reading test with three independent reading charts can be useful for clinical studies of reading ability before and after treatment.

Maximum reading speed and binocular summation in patients with central vision loss

ObjectiveVisual acuity is a poor predictor of the maximum reading speed of patients with central vision loss. This study examines the effects of binocular summation of acuity on the maximum reading speed of these patients. DesignProspective, observational case series. ParticipantsTwenty patients with central vision loss participated. MethodsMaximum reading speed was measured binocularly using the MNREAD acuity charts. Monocular and binocular acuities were measured with the Early Treatment Diabetic Retinopathy Study (ETDRS) chart. Binocular summation was evaluated with a binocular ratio (BR) calculated as the ratio between the acuity of the better eye to binocular acuity. Fixation stability and preferred retinal locus (PRL) distance from the former fovea were evaluated with the MP-1 microperimetre. ResultsSix patients experienced acuity summation (BR > 1.05), 5 experienced acuity inhibition (BR < 0.95), and 9 showed equality (BR = 1 ± 0.05). There were no differences in the mean acuity of the better eye, fixation stability, or PRL distance from the fovea of the 3 groups. Maximum reading speed was significantly slower (p < 0.05) for patients who experienced binocular inhibition (mean 42 ± 27 words/min [wpm], median 40 wpm) than for those who experienced binocular summation (mean 107 ± 39 wpm, median 108 wpm) or equality (mean 111 ± 62 wpm, median 90 wpm). BR correlated with the maximum reading speed for the overall sample (r[18] = 0.49, p = 0.03). BR together with PRL distance from the former fovea in the better eye explained 45% of the variance in maximum reading speed. ConclusionsBinocular summation of acuity rather than visual acuity alone affects maximum reading speed of patients with central vision loss. Patients with binocular inhibition read significantly slower than those with binocular summation or equality. Assessment of binocular summation is important when devising reading rehabilitation techniques.

THERAPEUTIC INTERVENTIONS FOR MACULAR DISEASES SHOW CHARACTERISTIC EFFECTS ON NEAR AND DISTANCE VISUAL FUNCTION

To compare therapy-induced reading and distance visual acuity (dVA) increases in neovascular age-related macular degeneration (nAMD) and uveitis-associated cystoid macular edema. This longitudinal study included 68 treatment-naive eyes: 39 subfoveal nAMD eyes with disrupted photoreceptor layers treated with monthly ranibizumab and 29 uveitis-associated cystoid macular edema eyes with intact photoreceptor layer treated with 1 triamcinolone injection. Patients were examined with high-definition optical coherence tomography, Early Treatment Diabetic Retinopathy Study dVA (logarithm of the minimum angle of resolution), reading acuity (logRADscore), and maximum reading speed (words per minute) over 3 months of therapy. In uveitis-associated cystoid macular edema, logarithm of the minimum angle of resolution and logRADscore improved 1 day post treatment, from 0.49 ± 0.28 to 0.39 ± 0.3 (P = 0.018) and 0.71 ± 0.53 to 0.56 ± 0.49 (P = 0.012), respectively. In nAMD, logarithm of the minimum angle of resolution improved 1 week after anti-vascular endothelial growth factor therapy from 0.59 ± 0.29 to 0.49 ± 0.24 (P = 0.002), with no change in logRADscore. One month after treatment, logRADscore improved from 1.09 ± 0.65 to 0.90 ± 0.60 (P = 0.002). In uveitis-associated cystoid macular edema, the recovery course of reading and dVA was comparable, and in nAMD, reading acuity recovery was delayed. Irrespective of disease, a small reduction in dVA resulted in a larger reading acuity decrease. Cystoid macular edema resolution was associated with rapid synchronous reading and dVA improvement, whereas nAMD was followed by faster recovery of distance than reading acuity. In both conditions, reading acuity expressed by critical angular resolution was more suppressed by active disease and recovered relatively more than distance acuity. These discrepancies indicate that reading acuity might be a more sensitive measure for vision decrease in macular diseases than dVA. Reading acuity seems to be an important adjunct assessing intravitreal therapy efficacy.

Working-Age Cataract Patients: Visual Results, Reading Performance, and Quality of Life with Three Diffractive Multifocal Intraocular Lenses

To compare the visual outcomes, reading performance, and quality of life (QoL) of working-age cataractous patients bilaterally implanted with 3 different diffractive multifocal intraocular lenses (MIOLs). Two-center, randomized, prospective, double-masked study. Sixty-three consecutive patients (126 eyes) seen at Ophthalmology Section, Palermo and Florence University, Italy, randomized to receive the ReSTOR SN6AD3 (Alcon Laboratories, Inc, Irvine, CA) (20patients, group A), ReSTOR SN6AD1 (Alcon Laboratories, Inc) (21 patients, group B), or TECNIS ZMA00 (Abbott Medical Optics, Santa Ana, CA) (22 patients, group C) MIOL. Phacoemulsification. One-year follow-up differences among the 3 MIOL groups in visual acuity, reading performance by MNREAD (Minnesota Laboratory for Low-Vision Research, University of Minnesota, Minneapolis, MN) reading acuity (RA), critical print size (CPS), and maximum reading speed (MRS) under mesopic and photopic conditions. Photopic and mesopic contrast sensitivity (CS) by Pelli-Robson test and patient satisfaction by National Eye Institute Refractive Error Quality of Life Instrument-42 (NEI RQL-42) questionnaire. Mean photopic uncorrected near visual acuity (UNVA), distance-corrected near visual acuity (DCNVA), and corrected near visual acuity (CNVA) did not differ among groups, with a preferred reading distance greater in group B (P< 0.0005). Photopic distance-corrected intermediate visual acuity (DCIVA) was best in group B (P= 0.001) and better in group C than in group A. Mesopic UNVA and DCNVA were worse in groups A and B compared with group C (P< 0.0005 in both cases), with better DCNVA in group B than in group A (P= 0.031). Mesopic uncorrected intermediate visual acuity (UIVA) and DCIVA were worst in group A, with better results ingroup C (P< 0.0005 and P= 0.001, respectively). Mesopic MNREAD RA was better in group C (P= 0.02), and mesopic MRS was higher in groups B and C than in group A (P= 0.002). The QoL scores by the NEI RQL-42 test exhibited no differences among groups in 9 over 13 scales. "Near vision" (P= 0.005), "symptoms" (P= 0.001), and "satisfaction with correction" scale scores (P= 0.030) were lowest in group A, and "appearance" scale score was lowest in group B (P= 0.045). Newer-generation aspheric diffractive MIOLs, especially low-add hybrid apodized or full diffractive, are highly suited for working-age cataractous patients in terms of visual outcomes, reading performance, and QoL. Intrinsic optical differences, such as optimization for computer or dim-light working, or night driving, could be useful tools to customize the IOL in each single case.

One Year Follow-up of Functional Recovery in Neovascular AMD During Monthly Anti-VEGF Treatment

To identify neurosensory recovery, testing different functional variables during monthly intravitreal standard anti-vascular endothelial growth factor (VEGF) therapy in neovascular age-related macular degeneration (AMD). Prospective interventional cohort study. Sixty-four treatment-naïve neovascular AMD patients with subfoveal lesions were treated and examined monthly for distance visual acuity, reading acuity, maximum reading speed, and contrast sensitivity and with microperimetry evaluating the percentage of absolute and relative scotoma and mean central retinal sensitivity weighted by area. Improvements in reading acuity, distance acuity, reading speed, contrast sensitivity, mean central retinal sensitivity, and scotoma area in dependence of age, lesion type, lesion size, and mean central retinal sensitivity were evaluated by a random-slope and random-intercept model. Recovery pattern of parameters was compared by correlating the individual slopes of each variable. Initially, a rapid short-term effect of anti-VEGF treatment was documented throughout all functional variables. Progressive functional gain over 1 year was observed for distance visual acuity (P = .011), contrast sensitivity (P ≤ .0001), and mean central retinal sensitivity (P ≤ .0001), but not for reading acuity (P = .31) and maximum reading speed (P = .94). Decrease of absolute scotoma area missed statistical significance over time (P = .053) and also fixation stability did not improve (P = .08). However, lesion size influenced the course of absolute scotoma area (P = .0015), while lesion type had no effect on any visual function variable evaluated. The individual slopes of reading acuity and distance visual acuity showed a moderate correlation; however, all other variables showed only a weak or no significant correlation among each other. Visual recovery in anti-VEGF therapy is reflected in a characteristic pattern of functional changes over time, whereas distance visual acuity does not seem to comprehensively reflect overall visual function gain.

Reading performance in patients with glaucoma evaluated using the MNREAD charts

Reading performance in glaucoma patients has yet to be studied. We hypothesized that glaucomatous visual field loss affects reading performance even in patients with good acuity and evaluated their reading performance quantitatively. A cross-sectional, comparative, non-interventional study. Forty-nine patients with early-moderate glaucomatous visual field loss OU with visual acuity better than 1.0 in the better and 0.7 in the worse eye. Reading performance in glaucoma patients was examined by the Japanese version of the Minnesota Reading Acuity Chart (MNREAD) were compared to that of age-matched normal subjects (n = 30). The study subjects consisted of the 21 men and 28 women. The mean age was 53.3 ± 12.6 years. Diagnosis included primary open-angle glaucoma (n = 22), normal-tension glaucoma (n = 22), developmental glaucoma (n = 4) and exfoliation glaucoma (n = 1). Reading parameters of glaucoma patients examined by MNREAD were: maximum reading speed (MRS), 329.9 ± 55.4 characters per min.; critical print size (CPS), 0.24 ± 0.14 logMAR; reading acuity (RA), 0.02 ± 0.12 log MAR, significantly lower than those of normal subjects (MRS 363.0 ± 42.9, CPS 0.09 ± 0.13 logMAR, RA -0.13 ± 0.10 logMAR, P < 0.01 for three parameters by unpaired t test). CPS in glaucoma subjects was negatively correlated with mean deviation of Humphrey Field Analyzer 10-2 and 30-2 programs in the better eye (r = -0.402, P < 0.005; r = -0.304, P < 0.05; respectively, by linear regression analysis). The reading performance deteriorated even in glaucoma patients with good acuity.

The effect of letter-stroke boldness on reading speed in central and peripheral vision

People with central vision loss often prefer boldface print over normal print for reading. However, little is known about how reading speed is influenced by the letter-stroke boldness of font. In this study, we examined the reliance of reading speed on stroke boldness, and determined whether this reliance differs between the normal central and peripheral vision. Reading speed was measured using the rapid serial visual presentation paradigm, where observers with normal vision read aloud short single sentences presented on a computer monitor, one word at a time. Text was rendered in Courier at six levels of boldness, defined as the stroke-width normalized to that of the standard Courier font: 0.27, 0.72, 1, 1.48, 1.89 and 3.04× the standard. Testings were conducted at the fovea and 10° in the inferior visual field. Print sizes used were 0.8× and 1.4× the critical print size (smallest print size that can be read at the maximum reading speed). At the fovea, reading speed was invariant for the middle four levels of boldness, but dropped by 23.3% for the least and the most bold text. At 10° eccentricity, reading speed was virtually the same for all boldness <1, but showed a poorer tolerance to bolder text, dropping by 21.5% for 1.89× boldness and 51% for the most bold (3.04×) text. These results could not be accounted for by the changes in print size or the RMS contrast of text associated with changes in stroke boldness. Our results suggest that contrary to the popular belief, reading speed does not benefit from bold text in the normal fovea and periphery. Excessive increase in stroke boldness may even impair reading speed, especially in the periphery.

Reading Performance in Infantile Nystagmus

To characterize reading deficits in infantile nystagmus (IN), to determine optimal font sizes for reading in IN, and to investigate whether visual acuity (VA) and severity of nystagmus are good indicators of reading performance in IN. Prospective cross-sectional study. Seventy-one participants with IN (37 idiopathic, 34 with albinism) and 20 age-matched controls. Reading performance was assessed using Radner reading charts and was compared with near logarithm of the minimum angle of resolution (logMAR) VA, nystagmus intensity, and foveation characteristics as quantified using eye movement recordings. Reading acuity (smallest readable font size), maximum reading speed, critical print size (font size below which reading is suboptimal), near logMAR VA, nystagmus intensity, and foveation characteristics (using the eXpanded Nystagmus Acuity Function). Using optimal reading conditions, maximum reading speeds were 18.8% slower in albinism and 14.7% slower in idiopathic IN patients compared with controls. Reading acuities were significantly worse (P<0.001) in IN patients compared with controls. Also, the range of font sizes over which reading speeds were less than the optimum were much larger in IN patients compared with controls (P<0.001). Reading acuity was correlated strongly to near VA (r(2) = 0.74 albinism, r(2) = 0.55 idiopathic), but was better than near VA in participants with poor VA. Near VA was a poor predictor of maximum reading speed. Nystagmus intensity and foveation were poor indicators of both reading acuity and maximum reading speed. Maximum reading speeds can be near normal in IN when optimal font sizes are provided, even in individuals with poor VA or intense nystagmus. However, reading performance in IN is acutely sensitive to font size limitations. Font sizes for optimal reading speeds in IN may be as much as 6 logMAR lines worse than the near VA. The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Courier: a better font for reading with age-related macular degeneration

ObjectiveThis study examines the reading performance of patients with age-related macular degeneration (AMD) using 4 readily available fonts. DesignExperimental study. ParticipantsTwenty-four patients with bilateral AMD participated. MethodsReading performance (reading acuity, critical print size, and maximum reading speed) was measured for all patients, using 4 versions of the MNRead charts. These charts were printed in the following fonts: Times New Roman (serif, proportionally spaced), Arial (sans serif, proportionally spaced), Courier (serif, mono spaced), and Andale Mono (sans serif, mono spaced). ResultsReading acuity was significantly better on the Courier chart (0.58±0.21 logMAR) and significantly worse on the Arial chart (0.69±0.20 logMAR) than on any of the other charts (P<0.05). A larger proportion of patients were able to read≥1 sentences on the Courier chart than on any of the other charts. Reading speed dropped below the limit for fluent reading first with the Arial chart. There was no difference in maximum reading speed with the 4 fonts, and differences in critical print size failed to reach significance (P = 0.052). ConclusionsFont has an effect on the reading performance of patients with AMD at print sizes close to their reading acuity. Courier was the most advantageous and Arial the worst font for reading smaller print. This is contrary to the advice given by agencies for the blind.

Difficulty with Out-Loud and Silent Reading in Glaucoma

We evaluated the impact of glaucoma on out-loud and silent reading. METHODS. Glaucoma patients with bilateral visual field (VF) loss and normally-sighted controls had the following parameters measured: speed reading an International Reading Speed Text (IReST) passage out loud, maximum out-loud MNRead chart reading speed, sustained (30 minutes) silent reading speed, and change in reading speed during sustained silent reading. Glaucoma subjects read slower than controls on the IReST (147 vs. 163 words per minute [wpm], P < 0.001), MNRead (172 vs. 186 wpm, P < 0.001), and sustained silent (179 vs. 218 wpm, P < 0.001) tests. In multivariable analyses adjusting for age, race, sex, education, employment, and cognition, IReST and MNRead reading speeds were 12 wpm (6%-7%) slower among glaucoma subjects compared to controls (P < 0.01 for both), while sustained silent reading speed was 16% slower (95% confidence interval [CI] = -24 to -6%, P = 0.002). Each 5 decibel (dB) decrement in better-eye VF mean deviation was associated with 6 wpm slower IReST reading (95% CI = -9 to -3%, P < 0.001), 5 wpm slower MNRead reading (95% CI = -7 to -2%, P < 0.001), and 9% slower sustained silent reading (95% CI = -13 to -6%, P < 0.001). A reading speed decline of 0.5 wpm/min or more over the sustained silent reading period was more common among glaucoma subjects than controls (odds ratio [OR] = 2.2, 95% CI = 1.0-4.9, P < 0.05). Reading speed is slower among glaucoma patients with bilateral VF loss, with the greatest impact present during sustained silent reading. Persons with glaucoma fatigue during silent reading, resulting in slower reading over time.

Development and validation of the Greek version of the MNREAD acuity chart

BackgroundThe aim of this study was to develop MNREAD acuity charts in the Greek language (MNREAD‐GR) and establish their repeatability in a normal‐sighted population.MethodsOne hundred and eighty Greek sentences were constructed based on the design principles of the Minnesota Low Vision Reading Test. The software used to validate them for width was adjusted to the parameters of the non‐Latin characters used in the Greek language (MNTest‐GR) and width‐validated sentences were then checked for literacy by two language teachers. Pilot testing followed in 20 adults and two groups of 20 children. Subsequently, three versions of the MNREAD‐GR chart were printed and validated for repeatability: 20 adults read MNREAD‐GR charts 1, 2 and 3 in random order over two sessions. A linear mixed‐model analysis was performed for near visual acuity (VA), maximum reading speed and critical print size to identify the contribution of each source (individual subject, session, chart and residual error) to the total variance. Subject variance determined the intraclass correlation coefficient.ResultsOne hundred of the initial 180 sentences were validated with MNTest‐GR and approved for literacy correctness. Of those, 57 sentences were selected after pilot testing, and used in the final printed chart in random distribution among three versions. The intraclass correlation coefficients were 0.72 for VA, 0.87 for maximum reading speed and 0.46 for critical print size. The between‐charts within‐session within‐subject component accounted for a maximum five per cent of the variance. The between‐sessions within‐subject component had a maximum of one per cent. The coefficient of repeatability was 0.08 logMAR for VA, 46.96 words per minute for maximum reading speed and 0.10 logMAR for critical print size.ConclusionThe created MNREAD‐GR acuity chart is a standardised clinical test that can be used reliably to measure near acuity, reading speed and critical print size in Greek‐speaking literate patients of all ages.

Bilateral reading performance of 4 multifocal intraocular lens models and a monofocal intraocular lens under bright lighting conditions

To compare changes in reading performance parameters after implantation of 4 multifocal intraocular lens (IOL) models and a monofocal IOL. Department of Ophthalmology, Paracelsus Medical University, Salzburg, Austria. Prospective randomized controlled clinical trial. Patients with bilateral cataract without additional ocular pathology were scheduled for bilateral implantation of Acri.Smart 48S monofocal, Acrysof Restor SN6AD3 apodized multifocal, AT LISA 366D diffractive multifocal, Tecnis ZMA00 diffractive multifocal, or Rezoom refractive multifocal IOLs. Bilateral corrected and uncorrected reading acuity, reading distance, mean and maximum reading speeds, and smallest log-scaled print size of a Radner reading chart were evaluated under bright lighting conditions (500 lux) using the Salzburg Reading Desk. Pupil size was not measured throughout the trial. The minimum follow-up was 12 months. The diffractive multifocal groups had significantly better uncorrected reading acuity and uncorrected smallest print size than the monofocal and refractive multifocal groups 1, 6, and 12months postoperatively. The diffractive IOL groups had comparable uncorrected reading distance of approximately 32 cm, which was larger in the monofocal group (38.9 ± 8.4 cm) and refractive multifocal group (37.1 ± 7.3 cm) at the last visit. Patients with diffractive IOLs could read print sizes of approximately 0.74 to 0.87 mm, which was much better than in the monofocal and refractive multifocal groups. The diffractive AT LISA IOL provided the best reading speed values (mean and maximum, corrected and uncorrected). Multifocal IOLs with a diffractive component provided good reading performance that was significantly better than that obtained with a refractive multifocal or monofocal IOL. Drs. Grabner and Dexl were patent owners of the Salzburg Reading Desk technology (now owned by SRD-Vision, LLC). No other author has a financial or proprietary interest in any material or method mentioned.

Effect of light‐emitting diode colour temperature on magnifier reading performance of the visually impaired

Background: As light‐emitting diodes become more common as the light source for low vision aids, the effect of illumination colour temperature on magnifier reading performance was investigated.Methods: Reading ability (maximum reading speed, critical print size, threshold near visual acuity) using Radner charts and subjective preference was assessed for 107 participants with visual impairment using three stand magnifiers with light emitting diode illumination colour temperatures of 2,700-K, 4,500-K and 6,000-K. The results were compared with distance visual acuity, prescribed magnification, age and the primary cause of visual impairment.Results: Reading speed, critical print size and near visual acuity were unaffected by illumination colour temperature (p > 0.05). Reading metrics decreased with worsening acuity and higher levels of prescribed magnification but acuity was unaffected by age. Each colour temperature was preferred and disliked by a similar number of patients and was unrelated to distance visual acuity, prescribed magnification and age (p > 0.05). Patients had better near acuity (p = 0.002), critical print size (p = 0.034) and maximum reading speed (p < 0.001), and the improvement in near from distance acuity was greater (p = 0.004) with their preferred rather than least‐liked colour temperature illumination.Conclusion: A range of colour temperature illuminations should be offered to all visually impaired individuals prescribed with an optical magnifier for near tasks to optimise subjective and objective benefits.

Guidelines for Predicting Performance with Low Vision Aids

To determine predictors of success in reading with low vision aids, in terms of reading acuity, optimum acuity reserve, and maximum reading speed, for observers with vision loss from various causes. One hundred people with vision loss affecting their daily lives participated. Clinical visual function measurements of distance acuity, contrast sensitivity, binocular threshold visual fields, and near reading performance with a MNRead chart at 40 cm were obtained. Reading performance aided by habitual low vision aids was also assessed with a MNRead chart. Aided reading acuity was best predicted by clinical reading acuity and contrast sensitivity. For most observers, a 2:1 acuity reserve was sufficient to achieve near-maximum reading speed, but one-third of observers with aided reading acuity better than 1.2 M required a higher acuity reserve. Aided maximum reading speed was best predicted by clinically assessed reading speed and by clinical reading acuity. People with vision impairment are likely to achieve 1 M with a low vision aid if their clinically assessed reading acuity is better than 0.85 logMAR. If acuity is worse than this, but contrast sensitivity is better than 1.05 logCS, 1M is also likely to be achieved. A 2:1 acuity reserve is adequate for 75% of observers, but those with good aided reading acuity may require further magnification to achieve best reading speeds. Fluent reading (>80 words per minute) is likely to be achieved if an observer reads fluently with large print at a fixed working distance and if clinically assessed reading acuity is better than 1.0 logMAR.

Reading performance and patient satisfaction after corneal inlay implantation for presbyopia correction: Two-year follow-up

To evaluate change in reading performance parameters after monocular Kamra corneal inlay implantation for the surgical correction of presbyopia. University surgical outpatient center. Prospective interventional case series. A corneal inlay was implanted in the nondominant eye. Naturally emmetropic and presbyopic patients between 45 years and 60 years old with an uncorrected distance visual acuity of at least 20/20 in both eyes without additional ocular pathology were eligible for inclusion. Bilateral uncorrected reading acuity, reading distance, mean and maximum reading speed, and the smallest log-scaled print size (lower case letter of a Radner reading chart) were evaluated using the Salzburg Reading Desk. The minimum postoperative follow-up was 24 months. Twenty-four patients were enrolled. The mean reading distance was 46.7 cm ± 6.3 (SD) preoperatively and 39.5 ± 6.4 cm 24 months postoperatively (P<.001). The mean reading acuity at best distance improved (0.33 ± 0.13 logRAD versus 0.23 ± 0.11 logRAD) (P=.004). The mean reading speed increased from 141 ± 20 words per minute (wpm) to 146 ± 20 wpm, respectively (P=.261), and the mean maximum reading speed from 171 ± 28 wpm to 180 ± 22 wpm, respectively (P=.110). The smallest print size improved from 1.50 ± 0.42 mm to 1.01 ± 0.22 mm, respectively (P<.001). Improving the depth of focus by monocular implantation of a small-aperture optic caused statistically significant changes in all tested reading performance parameters except reading speed metrics in emmetropic presbyopic patients.

Can reading-specific training stimuli improve the effect of perceptual learning on peripheral reading speed?

In a previous study, Chung, Legge, and Cheung (2004) showed that training using repeated presentation of trigrams (sequences of three random letters) resulted in an increase in the size of the visual span (number of letters recognized in a glance) and reading speed in the normal periphery. In this study, we asked whether we could optimize the benefit of trigram training on reading speed by using trigrams more specific to the reading task (i.e., trigrams frequently used in the English language) and presenting them according to their frequencies of occurrence in normal English usage and observers’ performance. Averaged across seven observers, our training paradigm (4days of training) increased the size of the visual span by 6.44bits, with an accompanied 63.6% increase in the maximum reading speed, compared with the values before training. However, these benefits were not statistically different from those of Chung, Legge, and Cheung (2004) using a random-trigram training paradigm. Our findings confirm the possibility of increasing the size of the visual span and reading speed in the normal periphery with perceptual learning, and suggest that the benefits of training on letter recognition and maximum reading speed may not be linked to the types of letter strings presented during training.

Effect of axis orientation on visual performance in astigmatic eyes

To determine the effect of axis orientation on visual performance in astigmatic eyes. Department of Ophthalmology, Kitasato University, Kanagawa, Japan. Investigational simulation. Healthy volunteers with no ophthalmic disease other than refractive errors were enrolled. After cycloplegic refraction was fully corrected with a 3.0 mm artificial pupil, with-the-rule (WTR), against-the-rule (ATR), and oblique (OBL) astigmatism of 1.0 diopter (D), 2.0 D, and 3.0 D were produced using trial lenses in each subject. Distance visual acuity and reading performance with uncorrected astigmatism imposed by the trial lenses under cycloplegia were assessed. Reading performance was determined from reading acuity and maximum reading speed using the Japanese version of the Minnesota Low Vision Reading Test acuity charts. Distance visual acuity and reading performance in the 38 volunteers decreased significantly with increasing astigmatism (P<.001, analysis of variance). Distance visual acuity, reading acuity, and maximum reading speed with uncorrected astigmatism were significantly affected by axis orientation at each diopter of astigmatism (P<.05, 1.0 D and 2.0 D; P<.001, 3.0 D). All parameters showed significantly better values in eyes with WTR or ATR astigmatism than in eyes with OBL astigmatism at each diopter (P<.05); there were no significant differences between eyes with WTR astigmatism and eyes with ATR astigmatism. Eyes with OBL astigmatism had significantly lower visual performance than eyes with WTR or ATR astigmatism. Correcting the preexisting astigmatism to acquire excellent visual outcomes may be necessary, especially in eyes with OBL astigmatism. No author has a financial or proprietary interest in any material or method mentioned.

Randomized Controlled Trial on the Effects of Training in the Use of Closed-Circuit Television on Reading Performance

To investigate the effectiveness of training in the use of closed-circuit television (CCTV) on reading performance in visually impaired patients. In a multicenter masked randomized controlled trial, 122 patients were randomized either to a treatment group that received usual delivery instructions from the CCTV supplier combined with concise outpatient standardized training, or to a control group that received delivery instructions only. The main outcome measure was reading performance, which was obtained by measuring reading acuity, reading speed, reading errors, column-tracking time, and technical reading, approximately two weeks after patients had received their CCTV and 3 months later. Videotapes of all measurements were rated by two investigators. Training effects were analyzed with linear mixed modeling. There were no statistically significant differences in results between the treatment and control group. However, introducing a CCTV increased reading acuity (mean difference [MD] 0.93 logRAD; P < 0.01) and maximum reading speed (MD 15 wpm; P < 0.01), and decreased the number of errors (MD 0.33; P = 0.04), compared to reading without CCTV. Average reading speed (P = 0.05), number of errors (P = 0.04), and column-tracking time (P = 0.01) improved over time. Prescribing a CCTV and the delivery instructions by the supplier seemed sufficient to improve reading performance. Additional training in the use of this device did not result in further improvement. Based on these results, outpatient low-vision rehabilitation centers may consider reallocating part of the training resources into other evidence-based rehabilitation programs. (trialregister.nl number, NTR1031.).