MNREAD

Our purpose was to compare reading performance measured with the MNREAD Acuity Chart and an iPad application (app) version of the same test for both normally sighted and low-vision participants. Our methods included 165 participants with normal vision and 43 participants with low vision tested on the standard printed MNREAD and on the iPad app version of the test. Maximum Reading Speed, Critical Print Size, Reading Acuity, and Reading Accessibility Index were compared using linear mixed-effects models to identify any potential differences in test performance between the printed chart and the iPad app. Our results showed the following: For normal vision, chart and iPad yield similar estimates of Critical Print Size and Reading Acuity. The iPad provides significantly slower estimates of Maximum Reading Speed than the chart, with a greater difference for faster readers. The difference was on average 3% at 100 words per minute (wpm), 6% at 150 wpm, 9% at 200 wpm, and 12% at 250 wpm. For low vision, Maximum Reading Speed, Reading Accessibility Index, and Critical Print Size are equivalent on the iPad and chart. Only the Reading Acuity is significantly smaller (I. E., better) when measured on the digital version of the test, but by only 0.03 logMAR (p = 0.013). Our conclusions were that, overall, MNREAD parameters measured with the printed chart and the iPad app are very similar. The difference found in Maximum Reading Speed for the normally sighted participants can be explained by differences in the method for timing the reading trials.

We define a Reading Accessibility Index for evaluating reading in individuals with normal and low vision. To compare the Reading Accessibility Index with data from the Impact of Cataracts on Mobility (ICOM) study. This investigation was a secondary data analysis from the ICOM study performed between July 1, 2014, and September 20, 2015, at 12 eye clinics in Alabama from October 1, 1994, through March 31, 1996. Participants were 321 adults with cataract (n = 92), pseudophakia (n = 131), or natural crystalline lenses without cataract (n = 98). The Reading Accessibility Index (hereafter referred to using the abbreviation ACC for the first 3 letters of Accessibility) is defined as an individual's mean reading speed measured across the 10 largest print sizes on the MNREAD Acuity Chart (Precision Vision) (0.4-1.3 logarithm of the minimum angle of resolution at 40 cm), normalized by 200 words per minute, which was the mean value for a group of 365 normally sighted young adults. The ACC is a single-value measure that captures an individual's range of accessible print sizes and reading fluency within this range. The study cohort comprised 321 participants. Their age range was 55 to 85 years, and 157 (48.9%) were female. The ACCs for the ICOM study participants ranged from 0.19 to 1.33, where 1.00 is the mean value for normally sighted young adults. The ACC for the cataract group (mean [SD], 0.65 [0.18]) was significantly lower than that for the pseudophakia group (mean [SD], 0.77 [0.16]) and the control group (mean [SD], 0.76 [0.19]) (P < .001 for both). The correlation between the ACC and Early Treatment Diabetic Retinopathy Study visual acuity (r = -0.22) and Pelli-Robson contrast sensitivity (r = 0.20) was weaker than that with a reading-related measure of instrumental activities of daily living (r = -0.60) (P < .001 for both). The ACC represents an individual's access to text across the range of print sizes found in everyday life. Its calculation does not rely on curve fitting and provides a direct comparison with the performance of normally sighted individuals. Changes in an individual's ACC might be used to evaluate the effect of ophthalmic treatment, rehabilitation programs, or assistive technology on reading accessibility. Data from the ICOM study show that the ACC reflects characteristics of reading performance in everyday life and is sensitive to improved reading accessibility for pseudophakic eyes.