A comparison of word recognition and reading performance in foveal and peripheral vision

Effect of Myopic Undercorrection on Habitual Reading Distance in Schoolchildren: The Hong Kong Children Eye Study

INTRODUCTION

This study aimed to evaluate the habitual reading distance among non-myopic children and also myopic children with undercorrection and with full correction.

METHODS

This was a population-based cross-sectional study with a total of 2363 children aged 6-8 years who were recruited from the Hong Kong Children Eye Study. Cycloplegic autorefraction, subjective refraction, habitual visual acuity, and best corrected visual acuity were measured. The entire reading process (9 min) was recorded using a hidden video camera placed 5 m away from the reading desk. Reading distances were taken at 6, 7, 8, and 9 min after the child began reading and were measured using a customized computer program developed in MATLAB. The main outcome was the association of habitual reading distances with refraction status. Habitual reading distances of children were documented via video camera footage.

RESULTS

The habitual reading distances of undercorrected myopic children (23.37 ± 4.31 cm) were the shortest when compared to non-myopic children (24.20 ± 4.73 cm, P = 0.002) and fully corrected myopic children (24.81 ± 5.21 cm, P < 0.001), while there was no significant difference between the last two children groups (P = 0.17). A shorter reading distance was associated with myopia (OR 1.67; 95% CI 1.11-2.51; P = 0.013) after adjusting for age, sex, height, near work time, outdoor time, and parental myopia. The association of reading distance with myopia did not hold after undercorrected myopic children were excluded (OR 0.97, 95% CI 0.55-1.73; P = 0.92). A shorter reading distance correlated with poorer vision under habitual correction (β = - 0.003, P < 0.001).

CONCLUSION

A shorter reading distance was present among undercorrected myopic children. Myopia undercorrection is not recommended as a strategy for slowing myopic progression.

Fonts of wider letter shapes improve letter recognition in parafovea and periphery

Most text on modern electronic displays is set in fonts of regular letter width. Little is known about whether this is the optimal font width for letter recognition. We tested three variants of the font family Helvetica Neue (Condensed, Standard, and Extended). We ran two separate experiments at different distances and different retinal locations. In Experiment 1, the stimuli were presented in the parafovea at 2° eccentricity; in Experiment 2, the stimuli were presented in the periphery at 9° eccentricity. In both experiments, we employed a short-exposure single-report trigram paradigm in which a string of three letters was presented left or right off-centre. Participants were instructed to report the middle letter while maintaining fixation on the fixation cross. Wider fonts resulted in better recognition and fewer misreadings for neighbouring letters than narrower fonts, which demonstrated that wider letter shapes improve recognition at glance reading in the peripheral visual view. Practitioner summary: Most of the text is set in fonts of regular letter width. In two single-target trigram letter recognition experiments, we showed that wider letter shapes facilitate better recognition than narrower letter shapes. This indicates that when letter identification is a priority, it is beneficial to choose fonts of wider letter shapes.

Perspective on Vision Science-Informed Interventions for Central Vision Loss

Pathologies affecting central vision, and macular degeneration (MD) in particular, represent a growing health concern worldwide, and the leading cause of blindness in the Western World. To cope with the loss of central vision, MD patients often develop compensatory strategies, such as the adoption of a Preferred Retinal Locus (PRL), which they use as a substitute fovea. However, visual acuity and fixation stability in the visual periphery are poorer, leaving many MD patients struggling with tasks such as reading and recognizing faces. Current non-invasive rehabilitative interventions are usually of two types: oculomotor, aiming at training eye movements or teaching patients to use or develop a PRL, or perceptual, with the goal of improving visual abilities in the PRL. These training protocols are usually tested over a series of outcome assessments mainly measuring low-level visual abilities (visual acuity, contrast sensitivity) and reading. However, extant approaches lead to mixed success, and in general have exhibited large individual differences. Recent breakthroughs in vision science have shown that loss of central vision affects not only low-level visual abilities and oculomotor mechanisms, but also higher-level attentional and cognitive processes. We suggest that effective interventions for rehabilitation after central vision loss should then not only integrate low-level vision and oculomotor training, but also take into account higher level attentional and cognitive mechanisms.

Reading: The Confluence of Vision and Language

The scientific study of reading has a rich history that spans disciplines from vision science to linguistics, psychology, cognitive neuroscience, neurology, and education. The study of reading can elucidate important general mechanisms in spatial vision, attentional control, object recognition, and perceptual learning, as well as the principles of plasticity and cortical topography. However, literacy also prompts the development of specific neural circuits to process a unique and artificial stimulus. In this review, we describe the sequence of operations that transforms visual features into language, how the key neural circuits are sculpted by experience during development, and what goes awry in children for whom learning to read is a struggle. Expected final online publication date for the Annual Review of Vision Science, Volume 7 is September 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Visual function: the problem with eccentricity

Age-related macular degeneration (AMD) is the leading cause of blindness in developed countries. With an ageing population, the prevalence of such a condition has resulted in a large proportion of the population relying on peripheral vision to undertake activities of daily living. Peripheral vision is not a scaled-down version of the fovea, simply requiring larger print or increased contrast for detection of objects or reading text. Even when print size is scaled and eye movements are minimised, the peripheral retina cannot perform at the level of the foveal region. Understanding how and why reading performance is limited as a function of eccentricity has important implications for how we approach rehabilitation of patients with central visual loss. This brief review of the extensive literature on reading with peripheral vision and the research aimed at better reading rehabilitation for low vision patients focuses on why many of the problems associated with the reduced reading capability of peripheral vision cannot be completely solved with magnification, reducing eye movements or modifying print.

Neural sources of letter and Vernier acuity

Visual acuity can be measured in many different ways, including with letters and Vernier offsets. Prior psychophysical work has suggested that the two acuities are strongly linked given that they both depend strongly on retinal eccentricity and both are similarly affected in amblyopia. Here we used high-density EEG recordings to ask whether the underlying neural sources are common as suggested by the psychophysics or distinct. To measure visual acuity for letters, we recorded evoked potentials to 3 Hz alternations between intact and scrambled text comprised of letters of varying size. To measure visual acuity for Vernier offsets, we recorded evoked potentials to 3 Hz alternations between bar gratings with and without a set of Vernier offsets. Both alternation types elicited robust activity at the 3 Hz stimulus frequency that scaled in amplitude with both letter and offset size, starting near threshold. Letter and Vernier offset responses differed in both their scalp topography and temporal dynamics. The earliest evoked responses to letters occurred on lateral occipital visual areas, predominantly over the left hemisphere. Later responses were measured at electrodes over early visual cortex, suggesting that letter structure is first extracted in second-tier extra-striate areas and that responses over early visual areas are due to feedback. Responses to Vernier offsets, by contrast, occurred first at medial occipital electrodes, with responses at later time-points being more broadly distributed—consistent with feedforward pathway mediation. The previously observed commonalities between letter and Vernier acuity may be due to common bottlenecks in early visual cortex but not because the two tasks are subserved by a common network of visual areas.

Retinotopy of emotion: Perception of negatively valenced stimuli presented at different spatial locations as revealed by event-related potentials

Scarce previous data on how the location where an emotional stimulus appears in the visual scene modulates its perception suggest that, for functional reasons, a perceptual advantage may exist, vertically, for stimuli presented at the lower visual field (LoVF) and, horizontally, for stimuli presented at the left visual field (LeVF). However, this issue has been explored through a limited number of spatial locations, usually in a single spatial dimension (e.g., horizontal) and invariant eccentricities. Event-related potentials (ERPs) were recorded from 39 participants perceiving brief neutral (wheels) and emotional stimuli (spiders) presented at 17 different locations, one foveal and 16 at different peripheral coordinates. As a secondary scope, we explored the role of the magnocellular (M) and the parvocellular (P) visual pathways by presenting an isoluminant/heterochromatic (P-biased) and a heteroluminant/isochromatic version (M-biased) of each stimulus. Emo > Neu effects were observed in PN1 (120 ms) for stimuli located at fovea, and in PN2 (215 ms) for stimuli located both at fovea and diverse peripheral regions. A factorial approach to these effects further revealed that: (a) emotional stimuli presented in the periphery are efficiently perceived, without evident decrease from para- to perifovea; (b) peripheral Emo > Neu effects are reflected 95 ms later than foveal Emo > Neu effects in ERPs; (c) LoVF is more involved than UVF in these effects; (d) our data fail to support the LeVF advantage previously reported, and (e) Emo > Neu effects were significant for both M and P stimuli.

Reading in the presence of macular disease: a mini-review

Purpose

Reading is vital to full participation in modern society. To millions of people suffering from macular disease that results in a central scotoma, reading is difficult and inefficient, rendering reading as the primary goal for most patients seeking low vision rehabilitation. The goals of this review paper are to summarize the dependence of reading speed on several key visual and typographical factors and the current methods or technologies for improving reading performance for people with macular disease.

Important findings

In general, reading speed for people with macular disease depends on print size, text contrast, size of the visual span, temporal processing of letters and oculomotor control. Attempts at improving reading speed by reducing the crowding effect between letters, words or lines; or optimizing properties of typeface such as the presence of serifs or stroke‐width thickness proved to be futile, with any improvement being modest at best. Currently, the most promising method to improve reading speed for people with macular disease is training, including perceptual learning or oculomotor training.

Summary

The limitation on reading speed for people with macular disease is likely to be multi‐factorial. Future studies should try to understand how different factors interact to limit reading speed, and whether different methods could be combined to produce a much greater benefit.

Age factor affects reading acuity and reading speed in attaining text information

AIM

To investigate the effect of age on reading acuity and reading speed in attaining text information in healthy eyes.

METHODS

Reading acuity, critical print size, reading speed and maximum reading speed were measured in groups of 40 children (8 to 12 years old), 40 teenagers (13 to 19 years old), 40 young adults (20 to 39 years old), and 40 adults (40 years old and above) using the Buari-Chen Malay Reading Chart [contextual sentences (CS) set and random words (RW) set] in a cross-sectional study design.

RESULTS

Reading acuity was significantly improved by 0.04 logMAR for both CS set and RW set from children to teenagers, then gradually worsened from young adults to adults (CS set: 0.06 logMAR; RW set: 0.08 logMAR). Critical print size for children showed a significant improvement in teenagers (CS set: 0.14 logMAR; RW set: 0.07 logMAR), then deteriorated from young adults to adults by 0.09 logMAR only for CS set. Reading speed significantly increased from children to teenagers, [CS set: 46.20 words per minute (wpm); RW set: 42.06 wpm], then stabilized from teenagers to young adults, and significantly reduced from young adults to adults (CS set: 28.58 wpm; RW set: 24.44 wpm). Increment and decrement in maximum reading speed measurement were revealed from children to teenagers (CS set: 39.38 wpm; RW set: 43.38 wpm) and from young adults to adults (CS set: 22.26 wpm; RW set: 26.31 wpm) respectively.

CONCLUSION

The reference of age-related findings in term of acuity and speed of reading should be incorporated in clinical practice to enhance reading assessment among healthy eyes population.

Disrupting uniformity: Feature contrasts that reduce crowding interfere with peripheral word recognition

Peripheral word recognition is impaired by crowding, the harmful influence of surrounding objects (flankers) on target identification. Crowding is usually weaker when the target and the flankers differ (for example in color). Here, we investigated whether reducing crowding at syllable boundaries improved peripheral word recognition. In Experiment 1, a target letter was flanked by single letters to the left and right and presented at 8° in the lower visual field. Target and flankers were either the same or different in regard to contrast polarity, color, luminance, and combined color/luminance. Crowding was reduced when the target differed from the flankers in contrast polarity, but not in any of the other conditions. Using the same color and luminance values as in Experiment 1, we measured recognition performance (speed and accuracy) for uniform (e.g., all letters black), congruent (e.g., alternating black and white syllables), and incongruent (e.g., alternating black and white non-syllables) words in Experiment 2. Participants verbally reported the target word, briefly displayed at 8° in the lower visual field. Congruent and incongruent words were recognized slower compared to uniform words in the opposite contrast polarity condition, but not in the other conditions. Our results show that the same feature contrast between the target and the flankers that yielded reduced crowding, deteriorated peripheral word recognition when applied to syllables and non-syllabic word parts. We suggest that a potential advantage of reduced crowding at syllable boundaries in word recognition is counteracted by the disruption of word uniformity.

Impact of simulated micro-scotomas on reading performance in central and peripheral retina

Observers with central field loss typically fixate within a non-foveal region called the preferred retinal locus, which can include localized sensitivity losses, or micro-scotomas (Krishnan and Bedell, 2018). In this study, we simulated micro-scotomas at the fovea and in the peripheral retina to assess their impact on reading speed. Ten younger (<36 years old) and 8 older (>50 years old) naïve observers with normal vision monocularly read high and/or low contrast sentences, presented at or above the critical print size for young observers at the fovea and at 5 and 10 deg in the inferior visual field. Reading material comprised MNREAD sentences and sentences taken from novels that were presented in rapid serial visual presentation (RSVP) format. Randomly distributed 13 × 13 arc min blocks corresponding to 0-78% of the text area (corresponding to ∼0-17 micro-scotomas/deg2) were set to the background luminance to simulate micro-scotomas. A staircase algorithm estimated maximum reading speed from the threshold exposure duration for each combination of retinal eccentricity, contrast and micro-scotoma density in both age groups. Log10(RSVP reading speed) decreased significantly with simulated micro-scotoma density and eccentricity. Across conditions, reading speed was slower with low-compared to high-contrast text and was faster in younger than older normal observers. For a given eccentricity and contrast, a higher density of random element losses maximally affected older observers with normal vision. These outcomes may explain some of the reading deficits observed in older observers with central field loss.

Emergent features in the crowding zone: When target-flanker grouping surmounts crowding

Crowding is the impairment of target identification when the target is surrounded by nearby flankers. Two hallmarks of crowding are that it is stronger when the flankers are close to the target and when the target strongly groups with the flankers. Here we show the opposite of both. A chevron target (pointing up or down) was presented at 8° eccentricity in the right visual field. It was surrounded by four flankers. Three of the flankers varied (pointing left or right). The fourth, the critical flanker (CF), was fixed in one orientation (left, right, up, down), yielding different configurations with the target. The CF's distance to the target was varied. Target identification depended strongly on the distance and the orientation of the CF. Remarkably, when the target and the CF grouped into a good configuration and elicited an emergent feature, performance was high if the CF was close to the target. This effect was particularly strong when participants were informed about the different CF-target configurations before the experiment. Reducing crowding and grouping by asynchronous presentation of the CF and the other items abolished the effect. When participants reported the entire configuration of the CF and the target, performance rapidly decreased with increasing spacing when the CF and the target were different but not when they were the same, indicating different spatial extents of the corresponding grouping processes. Our results show that the features emerging from the configurations of the target and a flanker strongly modulate crowding. Strong target-flanker grouping can benefit performance.

Reading with letter transpositions in central and peripheral vision

We used a letter transposition (LT) technique to investigate letter position coding during reading in central and peripheral vision. Eighteen subjects read aloud sentences in a rapid serial visual presentation task. The tests contained a baseline and three LT conditions with initial, internal, and final transpositions (e.g., “reading” to “erading”, “raeding”, and “readign”). The four reading conditions were tested in separate blocks. We found that LT had a smaller cost on peripheral (10° lower field) than on central reading speed, possibly due to the higher intrinsic position uncertainty of letters in the periphery. The pattern of cost (initial > final > internal) was the same for central and peripheral vision, indicating a similar lexical route for both. In the periphery, LT only affected transposed words, while in central vision it also affected untransposed words. This spread of the LT effect in central vision could not be accounted for by increased attention or memory load, or by decreased sentence context.

Extending the MNREAD sentence corpus: Computer-generated sentences for measuring visual performance in reading

The MNREAD chart consists of standardized sentences printed at 19 sizes in 0.1 logMAR steps. There are 95 sentences distributed across the five English versions of the chart. However, there is a demand for a much larger number of sentences: for clinical research requiring repeated measures, and for new vision tests that use multiple trials at each print size. This paper describes a new sentence generator that has produced over nine million sentences that fit the MNREAD constraints, and demonstrates that reading performance with these new sentences is comparable to that obtained with the original MNREAD sentences. We measured reading performance with the original MNREAD sentences, two sets of our new sentences, and sentences with shuffled word order. Reading-speed versus print-size curves were obtained for each sentence set from 14 readers with normal vision at two levels of blur (intended to simulate acuity loss in low vision) and with unblurred text. We found no significant differences between the new and original sentences in reading acuity and critical print size across all levels of blur. Maximum reading speed was 7% slower with the new sentences than with the original sentences. Shuffled sentences yielded slower maximum reading speeds and larger reading acuities than the other sentences. Overall, measures of reading performance with the new sentences are similar to those obtained with the original MNREAD sentences. Our sentence generator substantially expands the reading materials for clinical research on reading vision using the MNREAD test, and opens up new possibilities for measuring how text parameters affect reading.

Modeling diverse responses to filled and outline shapes in macaque V4

Visual area V4 is an important midlevel cortical processing stage that subserves object recognition in primates. Studies investigating shape coding in V4 have largely probed neuronal responses with filled shapes, i.e., shapes defined by both a boundary and an interior fill. As a result, we do not know whether form-selective V4 responses are dictated by boundary features alone or if interior fill is also important. We studied 43 V4 neurons in two male macaque monkeys ( Macaca mulatta) with a set of 362 filled shapes and their corresponding outlines to determine how interior fill modulates neuronal responses in shape-selective neurons. Only a minority of neurons exhibited similar response strength and shape preferences for filled and outline stimuli. A majority responded preferentially to one stimulus category (either filled or outline shapes) and poorly to the other. Our findings are inconsistent with predictions of the hierarchical-max (HMax) V4 model that builds form selectivity from oriented boundary features and takes little account of attributes related to object surface, such as the phase of the boundary edge. We modified the V4 HMax model to include sensitivity to interior fill by either removing phase-pooling or introducing unoriented units at the V1 level; both modifications better explained our data without increasing the number of free parameters. Overall, our results suggest that boundary orientation and interior surface information are both maintained until at least the midlevel visual representation, consistent with the idea that object fill is important for recognition and perception in natural vision. NEW & NOTEWORTHY The shape of an object's boundary is critical for identification; consistent with this idea, models of object recognition predict that filled and outline versions of a shape are encoded similarly. We report that many neurons in a midlevel visual cortical area respond differently to filled and outline shapes and modify a biologically plausible model to account for our data. Our results suggest that representations of boundary shape and surface fill are interrelated in visual cortex.

Korean reading speed: Effects of print size and retinal eccentricity

Evaluating the effects of print size and retinal eccentricity on reading speed is important for identifying the constraints faced by people with central-field loss. Previous work on English reading showed that 1) reading speed increases with print size until a critical print size (CPS) is reached, and then remains constant at a maximum reading speed (MRS), and 2) as eccentricity increases, MRS decreases and CPS increases. Here we extend this work to Korean, a language with more complex orthography. We recruited 6 Korean native speakers (mean age = 22) and measured their reading speed in central vision (0°) and peripheral vision (10° in the lower field). 900 Korean sentences (average 8.25 words) were created with frequently-occurring beginner-level words, presented using a rapid serial visual presentation (RSVP) paradigm. Data for English reading were obtained from Chung, Mansfield & Legge, Vision Research, 1998, for comparison. MRS was similar for Korean and English at 0° (713 vs. 787 wpm), but decreased faster with eccentricity for Korean. CPS was larger for Korean than for English regardless of eccentricity, but increased with eccentricity similarly for both languages. From 0 to 10°, MRS decreased by a factor of 6.5 for Korean and 2.8 for English, and CPS increased by a factor of 11.7 for Korean and 10.2 for English. Korean reading speed is more affected by retinal eccentricity than English, likely due to additional within-character crowding from more complex orthography. Korean readers with central-field loss may experience more difficulty than English readers.

Effects of monetary reward and punishment on information checking behaviour: An eye-tracking study

The aim of the present study was to investigate the effect of error consequence, as reward or punishment, on individuals' checking behaviour following data entry. This study comprised two eye-tracking experiments that replicate and extend the investigation of Li et al. (2016) into the effect of monetary reward and punishment on data-entry performance. The first experiment adopted the same experimental setup as Li et al. (2016) but additionally used an eye tracker. The experiment validated Li et al. (2016) finding that, when compared to no error consequence, both reward and punishment led to improved data-entry performance in terms of reducing errors, and that no performance difference was found between reward and punishment. The second experiment extended the earlier study by associating error consequence to each individual trial by providing immediate performance feedback to participants. It was found that gradual increment (i.e. reward feedback) also led to significantly more accurate performance than no error consequence. It is unclear whether gradual increment is more effective than gradual decrement because of the small sample size tested. However, this study reasserts the effectiveness of reward on data-entry performance.

Web pages: What can you see in a single fixation?

Research in human vision suggests that in a single fixation, humans can extract a significant amount of information from a natural scene, e.g. the semantic category, spatial layout, and object identities. This ability is useful, for example, for quickly determining location, navigating around obstacles, detecting threats, and guiding eye movements to gather more information. In this paper, we ask a new question: What can we see at a glance at a web page – an artificial yet complex “real world” stimulus? Is it possible to notice the type of website, or where the relevant elements are, with only a glimpse? We find that observers, fixating at the center of a web page shown for only 120 milliseconds, are well above chance at classifying the page into one of ten categories. Furthermore, this ability is supported in part by text that they can read at a glance. Users can also understand the spatial layout well enough to reliably localize the menu bar and to detect ads, even though the latter are often camouflaged among other graphical elements. We discuss the parallels between web page gist and scene gist, and the implications of our findings for both vision science and human-computer interaction.

Rehabilitation Approaches in Macular Degeneration Patients

Age related macular degeneration (AMD) is a visual disease that affects elderly population. It entails a progressive loss of central vision whose consequences are dramatic for the patient's quality of life. Current rehabilitation programs are restricted to technical aids based on visual devices. They only temporarily improve specific visual functions such as reading skills. Considering the rapid increase of the aging population worldwide, it is crucial to intensify clinical research on AMD in order to develop simple and efficient methods that improve the patient's visual performances in many different contexts. One very promising approach to face this challenge is based on perceptual learning (PL). Through intensive practice, PL can induce neural plasticity in sensory cortices and result in long-lasting enhancements for various perceptual tasks in both normal and visually impaired populations. A growing number of studies showed how appropriate PL protocols improve visual functions in visual disorders, namely amblyopia, presbyopia or myopia. In order to successfully apply these approaches to more severe conditions such as AMD, numerous challenges have to be overcome. Indeed, the overall elderly age of patients and the reduced cortical surface that is devoted to peripheral vision potentially limit neural plasticity in this population. In addition, ocular fixation becomes much less stable because patients have to rely on peripheral fixation spots outside the scotoma whose size keeps on evolving. The aim of this review article is to discuss the recent literature on this topic and to offer a unified approach for developing new rehabilitation programs of AMD using PL. We argue that with an appropriate experimental and training protocol that is adapted to each patient needs, PL can offer fascinating opportunities for the development of simple, non-expensive rehabilitation approaches a large spectrum of visual functions in AMD patients.

Perceptual and Cognitive Factors Imposing "Speed Limits" on Reading Rate: A Study with the Rapid Serial Visual Presentation

Adults read at high speed, but estimates of their reading rate vary greatly, i.e., from 100 to 1500 words per minute (wpm). This discrepancy is likely due to different recording methods and to the different perceptual and cognitive processes involved in specific test conditions. The present study investigated the origins of these notable differences in RSVP reading rate (RR). In six experiments we investigated the role of many different perceptual and cognitive variables. The presence of a mask caused a steep decline in reading rate, with an estimated masking cost of about 200 wpm. When the decoding process was isolated, RR approached values of 1200 wpm. When the number of stimuli exceeded the short-term memory span, RR decreased to 800 wpm. The semantic context contributed to reading speed only by a factor of 1.4. Finally, eye movements imposed an upper limit on RR (around 300 wpm). Overall, data indicate a speed limit of 300 wpm, which corresponds to the time needed for eye movement execution, i.e., the most time consuming mechanism. Results reconcile differences in reading rates reported by different laboratories and thus provide suggestions for targeting different components of reading rate.

The effects of crowding on eye movement patterns in reading

Crowding is a phenomenon that characterizes normal periphery limiting letter identification when other letters surround the signal. We investigated the nature of the reading limitation of crowding by analyzing eye-movement patterns. The stimuli consisted of two items varying across trials for letter spacing (spaced, unspaced and increased size), lexicality (words or pseudowords), number of letters (4, 6, 8), and reading modality (oral and silent). In Experiments 1 and 2 (oral and silent reading, respectively) the results show that an increase in letter spacing induced an increase in the number of fixations and in gaze duration, but a reduction in the first fixation duration. More importantly, increasing letter size (Experiment 3) produced the same first fixation duration advantage as empty spacing, indicating that, as predicted by crowding, only center-to-center letter distance, and not spacing per se, matters. Moreover, when the letter size was enlarged the number of fixations did not increase as much as in the previous experiments, suggesting that this measure depends on visual acuity rather than on crowding. Finally, gaze duration, a measure of word recognition, did not change with the letter size enlargement. No qualitative differences were found between oral and silent reading experiments (1 and 2), indicating that the articulatory process did not influence the outcome. Finally, a facilitatory effect of lexicality was found in all conditions, indicating an interaction between perceptual and lexical processing. Overall, our results indicate that crowding influences normal word reading by means of an increase in first fixation duration, a measure of word encoding, which we interpret as a modulatory effect of attention on critical spacing.

Measurement properties of continuous text reading performance tests

PURPOSE

Measurement properties of tests to assess reading acuity or reading performance have not been extensively evaluated. This study aims to provide an overview of the literature on available continuous text reading tests and their measurement properties.

METHODS

A literature search was performed in PubMed, Embase and PsycInfo. Subsequently, information on design and content of reading tests, study design and measurement properties were extracted using consensus-based standards for selection of health measurement instruments. Quality of studies, reading tests and measurement properties were systematically assessed using pre-specified criteria.

RESULTS

From 2334 identified articles, 20 relevant articles were found on measurement properties of three reading tests in various languages: IReST, MNread Reading Test and Radner Reading Charts. All three reading tests scored high on content validity. Reproducibility studies (repeated measurements between different testing sessions) of the IReST and MNread of commercially available reading tests in different languages were missing. The IReST scored best on inter-language comparison, the MNread scored well in repeatability studies (repeated measurements under the same conditions) and the Radner showed good reproducibility in studies.

CONCLUSIONS

Although in daily practice there are other continuous text reading tests available meeting the criteria of this review, measurement properties were described in scientific studies for only three of them. Of the few available studies, the quality and content of study design and methodology used varied. For testing existing reading tests and the development of new ones, for example in other languages, we make several recommendations, including careful description of patient characteristics, use of objective and subjective lighting levels, good control of working distance, documentation of the number of raters and their training, careful documentation of scoring rules and the use of Bland-Altman analyses or similar for reproducibility and repeatability studies.

The effect of normal aging and age-related macular degeneration on perceptual learning

We investigated whether perceptual learning could be used to improve peripheral word identification speed. The relationship between the magnitude of learning and age was established in normal participants to determine whether perceptual learning effects are age invariant. We then investigated whether training could lead to improvements in patients with age-related macular degeneration (AMD). Twenty-eight participants with normal vision and five participants with AMD trained on a word identification task. They were required to identify three-letter words, presented 10° from fixation. To standardize crowding across each of the letters that made up the word, words were flanked laterally by randomly chosen letters. Word identification performance was measured psychophysically using a staircase procedure. Significant improvements in peripheral word identification speed were demonstrated following training (71% ± 18%). Initial task performance was correlated with age, with older participants having poorer performance. However, older adults learned more rapidly such that, following training, they reached the same level of performance as their younger counterparts. As a function of number of trials completed, patients with AMD learned at an equivalent rate as age-matched participants with normal vision. Improvements in word identification speed were maintained at least 6 months after training. We have demonstrated that temporal aspects of word recognition can be improved in peripheral vision with training across a range of ages and these learned improvements are relatively enduring. However, training targeted at other bottlenecks to peripheral reading ability, such as visual crowding, may need to be incorporated to optimize this approach.

The Glenn A. Fry Award Lecture 2012: Plasticity of the visual system following central vision loss

Following the onset of central vision loss, most patients develop an eccentric retinal location outside the affected macular region, the preferred retinal locus (PRL), as their new reference for visual tasks. The first goal of this article is to present behavioral evidence showing the presence of experience-dependent plasticity in people with central vision loss. The evidence includes the presence of oculomotor re-referencing of fixational saccades to the PRL; the characteristics of the shape of the crowding zone (spatial region within which the presence of other objects affects the recognition of a target) at the PRL are more "foveal-like" instead of resembling those of the normal periphery; and the change in the shape of the crowding zone at a para-PRL location that includes a component referenced to the PRL. These findings suggest that there is a shift in the referencing locus of the oculomotor and the sensory visual system from the fovea to the PRL for people with central vision loss, implying that the visual system for these individuals is still plastic and can be modified through experiences. The second goal of the article is to demonstrate the feasibility of applying perceptual learning, which capitalizes on the presence of plasticity, as a tool to improve functional vision for people with central vision loss. Our finding that visual function could improve with perceptual learning presents an exciting possibility for the development of an alternative rehabilitative strategy for people with central vision loss.

Enhanced text spacing improves reading performance in individuals with macular disease

The search by many investigators for a solution to the reading problems encountered by individuals with no central vision has been long and, to date, not very fruitful. Most textual manipulations, including font size, have led to only modest gains in reading speed. Previous work on spatial integrative properties of peripheral retina suggests that ‘visual crowding’ may be a major factor contributing to inefficient reading. Crowding refers to the fact that juxtaposed targets viewed eccentrically may be difficult to identify. The purpose of this study was to assess the combined effects of line spacing and word spacing on the ability of individuals with age-related macular degeneration (ARMD) to read short passages of text that were printed with either high (87.5%) or low contrast (17.5%) letters. Low contrast text was used to avoid potential ceiling effects and to mimic a possible reduction in letter contrast with light scatter from media opacities. For both low and high contrast text, the fastest reading speeds we measured were for passages of text with double line and double word spacing. In comparison with standard single spacing, double word/line spacing increased reading speed by approximately 26% with high contrast text (p < 0.001), and by 46% with low contrast text (p < 0.001). In addition, double line/word spacing more than halved the number of reading errors obtained with single spaced text. We compare our results with previous reading studies on ARMD patients, and conclude that crowding is detrimental to reading and that its effects can be reduced with enhanced text spacing. Spacing is particularly important when the contrast of the text is reduced, as may occur with intraocular light scatter or poor viewing conditions. We recommend that macular disease patients should employ double line spacing and double-character word spacing to maximize their reading efficiency.

The mechanism of word crowding

Word reading speed in peripheral vision is slower when words are in close proximity of other words (Chung, 2004). This word crowding effect could arise as a consequence of interaction of low-level letter features between words, or the interaction between high-level holistic representations of words. We evaluated these two hypotheses by examining how word crowding changes for five configurations of flanking words: the control condition - flanking words were oriented upright; scrambled - letters in each flanking word were scrambled in order; horizontal-flip - each flanking word was the left-right mirror-image of the original; letter-flip - each letter of the flanking word was the left-right mirror-image of the original; and vertical-flip - each flanking word was the up-down mirror-image of the original. The low-level letter feature interaction hypothesis predicts similar word crowding effect for all the different flanker configurations, while the high-level holistic representation hypothesis predicts less word crowding effect for all the alternative flanker conditions, compared with the control condition. We found that oral reading speed for words flanked above and below by other words, measured at 10° eccentricity in the nasal field, showed the same dependence on the vertical separation between the target and its flanking words, for the various flanker configurations. The result was also similar when we rotated the flanking words by 90° to disrupt the periodic vertical pattern, which presumably is the main structure in words. The remarkably similar word crowding effect irrespective of the flanker configurations suggests that word crowding arises as a consequence of interactions of low-level letter features.

The effects of interletter spacing in visual-word recognition

Despite the importance of determining the effects of interletter spacing on visual-word recognition, this issue has often been neglected in the literature. The goal of the present study is to shed some light on this topic. The rationale is that a thin increase in interletter spacing, as in casino, may reduce lateral interference among internal letters without destroying a word's integrity and/or allow a more precise encoding of a word's letter positions. Here we examined whether identification times for word stimuli in a lexical decision task were faster when the target word had a slightly wider than default interletter spacing value relative to the default settings (e.g., casino vs. casino). In Experiment 1, we examined whether interletter spacing interacted with word-frequency, whereas in Experiment 2, we examined whether interletter spacing interacted with word length. Results showed that responses to words using a thin increase in interletter spacing were faster than the responses to words using the default settings-regardless of word-frequency and word length. Thus, interletter spacing plays an important role at modulating the identification of visually presented words.

Enhancing visual performance for people with central vision loss

People with central vision loss must use peripheral vision for visual tasks. It is well known that performance for almost all spatial tasks is worse in the normal periphery than in the normal fovea. The primary goal of my ongoing research is to understand the limiting factors and the potential for enhancing vision for people with central vision loss. Here I review my previous work related to understanding the limiting factors on reading, a task that is the primary complaint of many patients with age-related macular degeneration, the leading cause of visual impairment in the elderly. I also review my work related to enhancing visual functions in the normal periphery and how it may be applied to people with central vision loss.

Contrast polarity differences reduce crowding but do not benefit reading performance in peripheral vision

Previous studies have shown that the spatial extent of crowding in peripheral vision is reduced when a target letter and its flanking letters have opposite contrast polarity. We have examined if this reduction in crowding leads to improved reading performance. We compared the spatial extent of crowding, visual-span profiles (plots of letter-recognition accuracy versus letter position), and reading speed at 10 degrees inferior visual field, using white letters, black letters, or mixtures of white and black letters, presented on a mid-gray background. Consistent with previous studies, the spatial extent of crowding was reduced when the target and flanking letters had opposite contrast polarity. However, using mixed contrast polarity did not lead to improvements in visual-span profiles or reading speed.

Attention to Speech-Accompanying Gestures: Eye Movements and Information Uptake

There is growing evidence that addressees in interaction integrate the semantic information conveyed by speakers’ gestures. Little is known, however, about whether and how addressees’ attention to gestures and the integration of gestural information can be modulated. This study examines the influence of a social factor (speakers’ gaze to their own gestures), and two physical factors (the gesture’s location in gesture space and gestural holds) on addressees’ overt visual attention to gestures (direct fixations of gestures) and their uptake of gestural information. It also examines the relationship between gaze and uptake. The results indicate that addressees’ overt visual attention to gestures is affected both by speakers’ gaze and holds but for different reasons, whereas location in space plays no role. Addressees’ uptake of gesture information is only influenced by speakers’ gaze. There is little evidence of a direct relationship between addressees’ direct fixations of gestures and their uptake.

Reading speed does not benefit from increased line spacing in AMD patients

PURPOSE

Crowding, the adverse spatial interaction due to the proximity of adjacent targets, has been suggested as an explanation for slow reading in peripheral vision. Previously, we showed that increased line spacing, which presumably reduces crowding between adjacent lines of text, improved reading speed in the normal periphery (Chung, Optom Vis Sci 2004;81:525-35). The purpose of this study was to examine whether or not individuals with age-related macular degeneration (AMD) would benefit from increased line spacing for reading.

METHODS

Experiment 1: Eight subjects with AMD read aloud 100-word passages rendered at five line spacings: the standard single spacing, 1.5x, 2x, 3x, and 4x the standard spacing. Print sizes were 1x and 2x of the critical print size. Reading time and number of reading errors for each passage were measured to compute the reading speed. Experiment 2: Four subjects with AMD read aloud sequences of six 4-letter words, presented on a computer monitor using the rapid serial visual presentation (RSVP) paradigm. Target words were presented singly, or flanked above and below by two other words that changed in synchrony with the target word, at various vertical word separations. Print size was 2x the critical print size. Reading speed was calculated based on the RSVP exposure duration that yielded 80% of the words read correctly.

RESULTS

Averaged across subjects, reading speeds for passages were virtually constant for the range of line spacings tested. For sequences of unrelated words, reading speeds were also virtually constant for the range of vertical word separations tested, except at the smallest (standard) separation at which reading speed was lower.

CONCLUSIONS

Contrary to the previous finding that reading speed improved in normal peripheral vision, increased line spacing in passages, or increased vertical separation between words in RSVP, did not lead to improved reading speed in people with AMD.

Local motion processing limits fine direction discrimination in the periphery

Visual sensitivity is reduced in the periphery for many discrimination tasks. Previously it has been reported that motion coherence thresholds are higher for dot stimuli presented in the periphery, a finding that could arise either from (a) impaired motion integration or (b) from motion integrators inheriting more noisy local directional signals. We sought to disentangle these factors using an equivalent noise paradigm. We report a deterioration in discrimination thresholds in the periphery that does not result from reduced visibility and is fully accounted for by an increase in local directional uncertainty with no change in sampling efficiency. Changes in motion coherence thresholds with stimulus eccentricity, measured using similar stimuli, exhibit a high degree of inter-subject variability.

Relationship between visual span and reading performance in age-related macular degeneration

PURPOSE

Visual-span profiles are plots of letter-recognition accuracy as a function of letter position left and right of the point of fixation. Legge, Mansfield, and Chung [Legge, G. E., Mansfield, J. S., & Chung, S. T. L. (2001). Psychophysics of reading-XX. Linking letter recognition to reading speed in central and peripheral vision. Vision Research, 41(6), 725-743] proposed that reduced size of the visual span is a spatial factor limiting reading speed in patients with age-related macular degeneration (AMD). We have recently shown that a temporal property of letter recognition--the exposure time required for a high level of accuracy--is also a factor limiting reading speed in AMD [Cheong, A. M. Y., Legge, G. E., Lawrence, M. G., Cheung, S. H., & Ruff, M. (2007). Relationship between slow visual processing and reading speed in people with macular degeneration. Vision Research, 47, 2943-2965]. We measured the visual-span profiles of AMD subjects and assessed the relationship of the spatial and temporal properties of these profiles to reading speed.

METHODS

Thirteen AMD subjects and 11 age-matched normals were tested. Visual-span profiles were measured by using the trigram letter-recognition method described by Legge et al. (2001). Each individual's temporal threshold for letter recognition (80% accuracy criterion) was used as the exposure time for measuring the visual-span profile. Size of the visual span was computed as the area under the profile in bits of information transmitted. The information transfer rate in bits per second was defined as the visual-span size in bits divided by the exposure time in sec.

RESULTS

AMD visual-span sizes were substantially smaller (median of 23.9 bits) than normal visual-span sizes in central vision (median of 40.8 bits, p<.01). For the nine AMD subjects with eccentric fixation, the visual-span sizes (median of 20.6 bits) were also significantly smaller than visual spans of normal controls at 10 degrees below fixation in peripheral vision (median of 29.0 bits, p=.01). Information transfer rate for the AMD subjects (median of 29.5 bits/s) was significantly slower than that for the age-matched normals at both central and peripheral vision (median of 411.7 and 290.5 bits/s respectively, ps<.01). Information transfer rates were more strongly correlated with reading speed than the size of the visual span, and explained 36% of the variance in AMD reading speed.

CONCLUSION

Both visual-span size and information transfer rate were significantly impaired in the AMD subjects compared with age-matched normals. Information transfer rate, representing the combined effects of a reduced visual span and slower temporal processing of letters, was a better predictor of reading speed in AMD subjects than was the size of the visual span.

Learning to identify crowded letters: does it improve reading speed?

Crowding, the difficulty in identifying a letter embedded in other letters, has been suggested as an explanation for slow reading in peripheral vision. In this study, we asked whether crowding in peripheral vision can be reduced through training on identifying crowded letters, and if so, whether these changes will lead to improved peripheral reading speed. We measured the spatial extent of crowding, and reading speeds for a range of print sizes at 10 degrees inferior visual field before and after training. Following training, averaged letter identification performance improved by 88% at the trained (the closest) letter separation. The improvement transferred to other untrained separations such that the spatial extent of crowding decreased by 38%. However, averaged maximum reading speed improved by a mere 7.2%. These findings demonstrated that crowding in peripheral vision could be reduced through training. Unfortunately, the reduction in the crowding effect did not lead to improved peripheral reading speed.

Relationship between slow visual processing and reading speed in people with macular degeneration

PURPOSE

People with macular degeneration (MD) often read slowly even with adequate magnification to compensate for acuity loss. Oculomotor deficits may affect reading in MD, but cannot fully explain the substantial reduction in reading speed. Central-field loss (CFL) is often a consequence of macular degeneration, necessitating the use of peripheral vision for reading. We hypothesized that slower temporal processing of visual patterns in peripheral vision is a factor contributing to slow reading performance in MD patients.

METHODS

Fifteen subjects with MD, including 12 with CFL, and five age-matched control subjects were recruited. Maximum reading speed and critical print size were measured with rapid serial visual presentation (RSVP). Temporal processing speed was studied by measuring letter-recognition accuracy for strings of three randomly selected letters centered at fixation for a range of exposure times. Temporal threshold was defined as the exposure time yielding 80% recognition accuracy for the central letter.

RESULTS

Temporal thresholds for the MD subjects ranged from 159 to 5881 ms, much longer than values for age-matched controls in central vision (13 ms, p<0.01). The mean temporal threshold for the 11 MD subjects who used eccentric fixation (1555.8 +/- 1708.4 ms) was much longer than the mean temporal threshold (97.0 +/- 34.2 ms, p<0.01) for the age-matched controls at 10 degrees in the lower visual field. Individual temporal thresholds accounted for 30% of the variance in reading speed (p<0.05).

CONCLUSION

The significant association between increased temporal threshold for letter recognition and reduced reading speed is consistent with the hypothesis that slower visual processing of letter recognition is one of the factors limiting reading speed in MD subjects.

Shift in spatial scale in identifying crowded letters

Crowding refers to the increased difficulty in identifying a letter flanked by other letters. The purpose of this study was to determine if the peak sensitivity of the human visual system shifts to a different spatial frequency when identifying crowded letters, compared with single letters. We measured contrast thresholds for identifying the middle target letters in trigrams, for a range of spatial frequencies, letter separations and letter sizes, at the fovea and 5 degrees eccentricity. Plots of contrast sensitivity vs. letter frequency exhibit spatial tuning, for all letter sizes and letter separations tested. The peak tuning frequency grows as the 0.6-0.7 power of the letter size, independent of letter separation. At the smallest letter separation, peak tuning frequency occurs at a frequency that is 0.17 octaves higher for flanked than for unflanked letters at the fovea, and 0.19 octaves at 5 degrees eccentricity. This finding suggests that the human visual system shifts its sensitivity toward a higher spatial-frequency channel when identifying letters in the presence of nearby letters. However, the size of the shift is insufficient to account for the large effect of crowding in the periphery.

Acuity, crowding, reading and fixation stability

People with age-related macular disease frequently experience reading difficulty that could be attributed to poor acuity, elevated crowding or unstable fixation associated with peripheral visual field dependence. We examine how the size, location, spacing and instability of retinal images affect the visibility of letters and words at different eccentricities. Fixation instability was simulated in normally sighted observers by randomly jittering single or crowded letters or words along a circular arc of fixed eccentricity. Visual performance was assessed at different levels of instability with forced choice measurements of acuity, crowding and reading speed in a rapid serial visual presentation paradigm. In the periphery: (1) acuity declined; (2) crowding increased for acuity- and eccentricity-corrected targets; and (3), the rate of reading fell with acuity-, crowding- and eccentricity-corrected targets. Acuity and crowding were unaffected by even high levels of image instability. However, reading speed decreased with image instability, even though the visibility of the component letters was unaffected. The results show that reading performance cannot be standardised across the visual field by correcting the size, spacing and eccentricity of letters or words. The results suggest that unstable fixation may contribute to reading difficulties in people with low vision and therefore that rehabilitation may benefit from fixation training.

Beating the beat: reading can be faster than the frequency of eye movements in persons with congenital nystagmus

PURPOSE

Rapid serial visual presentation (RSVP) of text has been reported to foster higher reading rates than presentation in a continuous text (CT) format, possibly because scanning eye movements are minimized. We investigated how this might be relevant for persons with congenital nystagmus (CN).

METHODS

We evaluated whether reading rates differ in persons with CN for RSVP versus CT presentation of single sentences under otherwise similar conditions. In a second experiment, we presented unrelated words to observers with CN in RSVP format while measuring their eye movements to determine whether reading can occur during the high-velocity, nonfoveating periods of the CN wave form. Both sentences and random words were selected from the MNRead corpus and displayed at 2x, 4x, or 8x the threshold word size on a 21-inch computer monitor.

RESULTS

Subjects with CN have virtually equivalent maximum reading speeds of 449 and 448 words per minute, respectively, for RSVP and CT presentation of sentences. Typically, reading rates were faster than the frequency of CN, which suggests that subjects could read during the nonfoveating periods of the nystagmus waveform. This finding was confirmed using random words that, unlike those in sentences, cannot be inferred from contextual cues. Examination of eye movements recorded during reading indicated that random words are read correctly with 47% to 65% accuracy (depending on word size) during the nonfoveating periods of the CN waveform.

CONCLUSION

A clinical implication of these results is that reading performance in persons with CN should be facilitated by large text sizes that remain legible during a greater fraction of the CN waveform.

Low-vision reading speed: influences of linguistic inference and aging

PURPOSE

Reading is a dynamic task involving both linguistic and visual analysis. In this study, we asked how two types of linguistic information--characters used in segmenting words from one another, and sentence context--differ in their usefulness for people with normal and low vision. Given evidence for age-related differences in some forms of cognitive processing, we also investigated the effect of age.

METHODS

There were four groups of 10 participants: vision status (normal, low) crossed with age (young, <35 years; old, >65 years). Reading speeds were compared for regularly spaced text and text in which the spaces were removed, a manipulation intended to eliminate local cues for text segmentation and force attention to clusters of letters or whole words. We also evaluated the effect of sentence context by comparing reading speeds for regular sentences and sentences in which word order was scrambled.

RESULTS

Removal of spaces had a greater impact on low vision than normal vision, reducing average speeds to 45% and 66% of speeds for regularly spaced text, respectively. We interpret this to mean that people with low vision have less access to spatially distributed linguistic regularities of text such as prefixes, suffixes, or word length. Removal of sentence context through scrambling had a greater impact on normal vision than low vision, reducing mean reading speed to 53% and 66%, respectively. Finally, comparison of our young and old readers showed no major differences in the use of sentence context or in the impact of removing spaces between words.

CONCLUSIONS

People with low vision appear to rely more on spacing information in sentences, whereas people with normal vision appear to make better use of sentence context, irrespective of age.

Rapid categorization of foveal and extrafoveal natural images: associated ERPs and effects of lateralization

Humans are fast and accurate at performing an animal categorization task with natural photographs briefly flashed centrally. Here, this central categorization task is compared to a three position task in which photographs could appear randomly either centrally, or at 3.6 degrees eccentricity (right or left) of the fixation point. A mild behavioral impairment was found with peripheral stimuli with no evidence in support of hemispheric superiority; but enlarging the window of spatial attention to three possible stimuli locations had no behavioral cost on the processing of central images. Performance in the central categorization task has been associated with a large difference between the potentials evoked to target and non-target correct trials, starting about 150 ms after stimulus onset on frontal sites. Present results show that this activity originates within extrastriate visual cortices and probably reflects perceptual stimuli differences processed within areas involved in object recognition. Latencies, slopes, and peak amplitudes of this differential activity were invariant to stimulus position and attentional load. Stimulus location uncertainty and lateralization did not affect speed of visual processing.

Reading Speed Benefits from Increased Vertical Word Spacing in Normal Peripheral Vision

PURPOSE

Crowding, the adverse spatial interaction due to proximity of adjacent targets, has been suggested as an explanation for slow reading in peripheral vision. The purposes of this study were to (1) demonstrate that crowding exists at the word level and (2) examine whether or not reading speed in central and peripheral vision can be enhanced with increased vertical word spacing.

METHODS

Five normal observers read aloud sequences of six unrelated four-letter words presented on a computer monitor, one word at a time, using rapid serial visual presentation (RSVP). Reading speeds were calculated based on the RSVP exposure durations yielding 80% correct. Testing was conducted at the fovea and at 5 degrees and 10 degrees in the inferior visual field. Critical print size (CPS) for each observer and at each eccentricity was first determined by measuring reading speeds for four print sizes using unflanked words. We then presented words at 0.8x or 1.4x CPS, with each target word flanked by two other words, one above and one below the target word. Reading speeds were determined for vertical word spacings (baseline-to-baseline separation between two vertically separated words) ranging from 0.8x to 2x the standard single-spacing, as well as the unflanked condition.

RESULTS

At the fovea, reading speed increased with vertical word spacing up to about 1.2x to 1.5x the standard spacing and remained constant and similar to the unflanked reading speed at larger vertical word spacings. In the periphery, reading speed also increased with vertical word spacing, but it remained below the unflanked reading speed for all spacings tested. At 2x the standard spacing, peripheral reading speed was still about 25% lower than the unflanked reading speed for both eccentricities and print sizes. Results from a control experiment showed that the greater reliance of peripheral reading speed on vertical word spacing was also found in the right visual field.

CONCLUSIONS

Increased vertical word spacing, which presumably decreases the adverse effect of crowding between adjacent lines of text, benefits reading speed. This benefit is greater in peripheral than central vision.

Simulation of artificial vision: II. Eccentric reading of full-page text and the learning of this task

Reading of isolated words in conditions mimicking artificial vision has been found to be a difficult but feasible task. In particular at relatively high eccentricities, a significant adaptation process was required to reach optimal performances [Vision Res. 43 (2003) 269]. The present study addressed the task of full-page reading, including page navigation under control of subject's own eye movements. Conditions of artificial vision mimicking a retinal implant were simulated by projecting stimuli with reduced information content (lines of pixelised text) onto a restricted and eccentric area of the retina. Three subjects, naïve to the task, were trained for almost two months (about 1 h/day) to read full-page texts. Subjects had to use their own eye movements to displace a 10 degrees x 7 degrees viewing window, stabilised at 15 degrees eccentricity in their lower visual field. Initial reading scores were very low for two subjects (about 13% correctly read words), and astonishingly high for the third subject (86% correctly read words). However, all of them significantly improved their performance with time, reaching close to perfect reading scores (ranging from 86% to 98% correct) at the end of the training process. Reading rates were as low as 1-5 words/min at the beginning of the experiment and increased significantly with time to 14-28 words/min. Qualitative text understanding was also estimated. We observed that reading scores of at least 85% correct were necessary to achieve 'good' text understanding. Gaze position recordings, made during the experimental sessions, demonstrated that the control of eye movements, especially the suppression of reflexive vertical saccades, constituted an important part of the overall adaptive learning process. Taken together, these results suggest that retinal implants might restore full-page text reading abilities to blind patients. About 600 stimulation contacts, distributed on an implant surface of 3 x 2 mm2, appear to be a minimum to allow for useful reading performance. A significant learning process will however be required to reach optimal performance with such devices, especially if they have to be placed outside the foveal area.

Letter-recognition and reading speed in peripheral vision benefit from perceptual learning

Visual-span profiles are plots of letter-recognition accuracy as a function of letter position left or right of the midline. Previously, we have shown that contraction of these profiles in peripheral vision can account for slow reading speed in peripheral vision. In this study, we asked two questions: (1) can we modify visual-span profiles through training on letter-recognition, and if so, (2) are these changes accompanied by changes in reading speed? Eighteen normally sighted observers were randomly assigned to one of three groups: training at 10 degrees in the upper visual field, training at 10 degrees in the lower visual field and a no-training control group. We compared observers' characteristics of reading (maximum reading speed and critical print size) and visual-span profiles (peak amplitude and bits of information transmitted) before and after training, and at trained and untrained retinal locations (10 degrees upper and lower visual fields). Reading speeds were measured for six print sizes at each retinal location, using the rapid serial visual presentation paradigm. Visual-span profiles were measured using a trigram letter-recognition task, for a letter size equivalent to 1.4x the critical print size for reading. Training consisted of the repeated measurement of 20 visual-span profiles (over four consecutive days) in either the upper or lower visual field. We also tracked the changes in performance in a sub-group of observers for up to three months following training. We found that the visual-span profiles can be expanded (bits of information transmitted increased by 6 bits) through training with a letter-recognition task, and that there is an accompanying increase (41%) in the maximum reading speed. These improvements transferred, to a large extent, from the trained to an untrained retinal location, and were retained, to a large extent, for at least three months following training. Our results are consistent with the view that the visual span is a bottleneck on reading speed, but a bottleneck that can be increased with practice.

The effect of text orientation, visual meridian, and inter-character spacing on word identification in the retinal periphery

Previous research has demonstrated that the masking effects of flankers about a target in the peripheral retina are not isotropic. Rather, regions of lateral interaction are ellipsoid in shape with the major axis oriented radially along a meridian through the fovea. This finding leads to the counterintuitive prediction that horizontal text positioned to the right of fixation might be read more slowly than similarly positioned text oriented diagonally or vertically. Similarly, vertically oriented text above fixation might be read more slowly than horizontally or diagonally oriented text above fixation. We investigated the effect of text orientation and inter-character spacing on word identification in the retinal periphery. Text was presented by rapid serial visual presentation. Words were centered 3 degrees from fixation along four visual field meridians (VM) (right horizontal, upper-right diagonal, vertical, and upper-left diagonal). Regardless of VM identification, performance was best for horizontal text, declining slightly for orientations between +60 degrees and -60 degrees and declining more quickly for acute orientations. A weak effect of VM was observed for text with normal inter-character spacing. Performance was best for text centered along the horizontal meridian and declined slightly along the other VM. Finally, identification rates increased by approximately 33 words min(-1) with the addition of one character space between adjacent letters. The word-recognition processes are very tolerant of text orientation, exhibiting a modest decline for orientations within +/- 60 of horizontal regardless of VM.