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Loh L, Prem-Senthil M, Constable PA. Visual acuity and reading print size requirements in children with vision impairment. Clin Exp Optom 2024; 107:709-715. [PMID: 37952256 DOI: 10.1080/08164622.2023.2279190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 08/07/2023] [Accepted: 10/30/2023] [Indexed: 11/14/2023] Open
Abstract
CLINICAL RELEVANCE The support of students with a vision impairment throughout education could be enhanced by assessing the functional reading ability of the individual. This visual assessment could inform educators of individualised student needs and potentially improve the academic achievement for these students. BACKGROUND Support for children with a vision impairment within a classroom is typically based on clinical findings of distance visual acuity and visual fields. Therefore, determining optimal print size for reading is essential to ensure best academic outcomes. Secondary aims were to investigate the possible impact of underlying pathology on reading ability. METHODS Forty-seven participants were recruited from a state-wide support service for children with a vision impairment in South Australia. Three visual acuity groups were formed based on World Health Organisation definitions of mild, moderate, and severe vision impairment. Correlation between clinical measures of distance visual acuity using the Freiburg Visual Acuity Test, were compared with reading acuity and critical print size (smallest font before reading speed reduced) using Minnesota low vision reading chart (MNREAD). RESULTS No significant correlations were found for mild (0.20-0.49 logMAR) and severe (1.00-1.52 logMAR) vision impairment groups between distance visual acuity and reading acuity read (p = .64, CI [-.585, .395]/p = .82, CI [-.48, .58]) or critical print size (p = .78, CI [-.57, .45]/p = .43, CI [-.34, .68]. A significant correlation was found for the moderate vision impairment group: 0.50-0.99 logMAR for minimum reading acuity (p < .001, CI [.44, .91]) and critical print size (p = .03, CI [.05, .80]). CONCLUSIONS Standard clinical measures of distance visual acuity are an unpredictable estimate of reading ability in children with mild and severe vision impairment. Additional measures of functional near reading ability could provide a more meaningful indicator of reading ability and help provide optimum support to students through education.
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Affiliation(s)
| | | | - Paul A Constable
- College of Nursing and Health Sciences, Caring Futures Institute, Flinders University, Bedford Park, South Australia, Australia
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Costa MF, Henriques LD, Souza GS. Validation of a computerized version of the MNREAD chart for children. Int Ophthalmol 2024; 44:127. [PMID: 38466499 DOI: 10.1007/s10792-024-03056-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/16/2024] [Indexed: 03/13/2024]
Abstract
PURPOSE We aimed the develop and validate a computerized version of the MNREAD for the assessment of reading speed for children. METHODS A computerized version of the MNREAD was built in Psykinematix software using the same parameters as the physical chart. We measured the reading velocity of 104 children (n = 44 of the 3rd grade; n = 60 of the 5th grade). Bland-Altaman analysis was used to quantify agreement between two chart measurements. RESULTS Comparison between the 3rd and 5th-grade children for physical and computerized MNREAD versions showed statistical differences in Maximum Reading Speed (F = 2669.6; p < 0.001), Critical Print Size (F = 17.49; p < 0.001), and Reading Acuity (F = 14.19; p = 0.002) with huge effect size (η2 = 0.930). No differences were found between the versions within grades. Bland-Altman analysis showed 95% of the data points within ± 2 s of the mean difference, suggesting a similarity between versions of the MNREAD parameters. CONCLUSION Our reading speed values for children in the 5th grade were higher than previous studies, suggesting a better quality of the assessment in the computerized version. Tolerance Limits were calculated as normality references for clinical purposes.
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Affiliation(s)
- Marcelo Fernandes Costa
- Departamento de Psicologia Experimental, Instituto de Psicologia, Universidade de São Paulo, São Paulo, Brasil.
- Programa de Pós-Graduação em Neurociências e Comportamento, Depto. Psicologia Experimental, Instituto de Psicologia, Universidade de São Paulo, Av. Prof. Mello Moraes, 1721, 05508-030, São Paulo, Brasil.
| | - Leonardo Dutra Henriques
- Departamento de Psicologia Experimental, Instituto de Psicologia, Universidade de São Paulo, São Paulo, Brasil
| | - Givago Silva Souza
- Instituto de Ciências Biológicas e Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brasil
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Kwon M, Owsley C. Reading Vision in Adults With Early and Intermediate Age-Related Macular Degeneration Under Mesopic and Photopic Conditions. Transl Vis Sci Technol 2023; 12:7. [PMID: 37676678 PMCID: PMC10494985 DOI: 10.1167/tvst.12.9.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 08/02/2023] [Indexed: 09/08/2023] Open
Abstract
Purpose Reading is involved in various daily activities that operate under a wide range of luminance levels. Rod- and cone-mediated mesopic visual function is known to be impaired even in early/intermediate age-related macular degeneration (AMD). It remains unclear whether and to what extent mesopic reading is impaired in early/intermediate AMD. Here, we assessed differences in reading vision between photopic and mesopic conditions in early/intermediate AMD and compared their performance to those in older adults with normal macular health. Methods The study included 30 patients with early/intermediate AMD and 30 healthy controls. Reading performance was tested on the MNREAD iPad app under mesopic (2 cd/m2 with a neural-density filter) and photopic (220 cd/m2) conditions. Four reading indices-maximum reading speed (MRS), critical print size (CPS), reading acuity (RA), and reading accessibility index (ACC)-were obtained from the MNREAD test, yielding a function representing reading speed versus print size. Results Compared to photopic conditions, patients with AMD and healthy controls both exhibited noticeable decreases in reading vision under mesopic conditions (P < 0.001) despite normal photopic visual acuity. This decrease was more pronounced in AMD even after adjusting for age (P < 0.001): Under mesopic conditions, MRS and ACC decreased by 8 words per minute and 0.1, respectively; CPS and RA were enlarged by 0.27 and 0.24 logMAR, respectively. Conclusions Reading vision deteriorates under mesopic conditions compared to photopic conditions in early/intermediate AMD and is accentuated compared to this difference in healthy controls. Translational Relevance A mesopic reading test may provide a more sensitive and comprehensive assessment of a patient's reading impairment.
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Affiliation(s)
- MiYoung Kwon
- Department of Psychology, Northeastern University, Boston, MA, USA
| | - Cynthia Owsley
- Department of Ophthalmology and Visual Sciences, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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DeCarlo DK, Gao L, McGwin G, Owsley C, Kwon M. Repeatability and Validity of MNREAD Test in Children With Vision Impairment. Transl Vis Sci Technol 2020; 9:25. [PMID: 33384883 PMCID: PMC7757625 DOI: 10.1167/tvst.9.13.25] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Accepted: 08/27/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the test-retest reliability and validity of the MNREAD test for use in children with vision impairment (VI) and to compare their performance on the test to that of normally sighted children. Methods Children with VI (n = 62) and without VI (n = 40) were administered the MNREAD test and the Basic Reading Inventory (BRI) on two study visits, 1 to 3 weeks apart. The maximum reading rate, critical print size, and reading acuity were determined for the MNREAD test, and test-retest reliability was evaluated. The reading rate for the MNREAD test was compared to the BRI results. Results Strong correlations between visits were found for all MNREAD parameters (0.68-0.99). Older, but not younger, children with VI read significantly more slowly on both the MNREAD and the BRI than children with normal vision (P < 0.05). Reading rates between the two tests were strongly correlated (r = 0.88). For the MNREAD test, the reading rate increased 4.4 words per minute (wpm) per year for VI and 10.6 wpm/y for those with normal vision. For the BRI, the reading rate increased by 5.9 wpm/y for VI and 9.7 wpm/y for those with normal vision. Poorer visual acuity was associated with slower reading rates on the MNREAD test but not on the BRI, as the MNREAD relies largely on visual factors but the BRI also relies on linguistic and grammar skills. Conclusions The MNREAD test are reliable and valid for use in children with vision impairment. Translational Relevance The MNREAD test can be utilized by clinicians, as they are a quick, easy-to-administer method for evaluating reading vision in children with VI.
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Affiliation(s)
- Dawn K DeCarlo
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Optometry, School of Optometry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Liyan Gao
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gerald McGwin
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Surgery, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Cynthia Owsley
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - MiYoung Kwon
- Department of Ophthalmology and Visual Sciences, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
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Elham R, Jafarzadepur E. Development and Validation of the Persian Version of the MNREAD Acuity Chart. J Curr Ophthalmol 2020; 32:274-280. [PMID: 32775803 PMCID: PMC7382509 DOI: 10.4103/joco.joco_80_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 03/03/2020] [Accepted: 03/29/2020] [Indexed: 11/28/2022] Open
Abstract
Purpose: To develop the Persian version of MNREAD acuity charts and test their repeatability in a normal adult population. Methods: Two hundred sentences were constructed using the most frequent words of 8-year-olds schoolbooks. The number of characters and sentence length were adjusted based on the design principles of the Minnesota Low Vision Reading Test. Two Persian language teachers checked the sentences for syntax and meaning. The accepted sentences were read by 20 adults and then by 20 children. Using RADNER charts method, the sentences with inappropriate reading time and repeated errors were excluded. Thirty-eight sentences were approved to create charts. To check the charts' validity and repeatability, 20 adults read both charts and a paragraph of a daily newspaper. Reading acuity, critical print size, and maximum reading speed were calculated. The measured reading speeds were compared to the readers' reading speeds for a paragraph of a daily newspaper. Bland-Altman plots were used to evaluate the agreement between the two charts. Results: Thirty-eight selected sentences were used in the final printed charts. There were significant correlations between maximum reading speed for Charts 1 and 2 (r = 0.87, P < 0.0001), Chart 1 and newspaper paragraph (r = 0.73, P = 0.001), and Chart 2 and newspaper paragraph (r = 0.83, P = 0.0001). Correlations were observed between reading acuities and critical print sizes of two charts (r = 0.72, P < 0.002 and r = 0.77, P = 0.00). The 95% limits of agreement in reading acuity, critical print size, and reading speed between Charts 1 and 2 were ± 0.034 logMAR, ±0.11 logMAR, and ±8.00 words per minute, respectively. Conclusion: The designed Persian MNREAD charts are repeatable and could be used reliably to calculate near acuity, reading speed, and critical print size in Persian-speaking people.
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Affiliation(s)
| | - Ebrahim Jafarzadepur
- Noor Ophthalmology Research Center, Noor Eye Hospital, Tehran, Iran.,Department of Optometry, Faculty of Rehabilitation, Iran University of Medical Sciences, Tehran, Iran
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Tanabe H, Obana A, Yamamoto S, Ichikumi K, Gohto Y, Seto T, Moriyama T. Potential roles of MNREAD acuity charts and contrast/glare sensitivity in Ranibizumab treatment of branch retinal vein occlusion. PLoS One 2020; 15:e0235897. [PMID: 32649680 PMCID: PMC7351188 DOI: 10.1371/journal.pone.0235897] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 06/24/2020] [Indexed: 11/19/2022] Open
Abstract
Background/Objectives To investigate the potential utility of MNREAD acuity charts and contrast/glare sensitivity (CGS) assessment for evaluating the efficacy of an initial treatment with ranibizumab (Lucentis®) for branch retinal vein occlusion (BRVO). Methods Intravitreal injections of ranibizumab were administered in 43 eyes of 43 treatment-naïve patients with BRVO. Efficacy was assessed 1 month later. Best-corrected far/near visual acuity (BCFVA/BCNVA), MNREAD parameters (reading acuity [RA], maximum reading speed [MRS], critical print size [CPS]), CGS (CS/GS), and central macular thickness (CMT) in optical coherence tomography (OCT) before and after treatment were evaluated. The area (superior/inferior) affected by BRVO was determined by fluorescein angiography. Results All parameters improved significantly following treatment (p < 0.05), and all MNREAD and CGS parameters were significantly correlated with BCVA in the treated eye before and after treatment (p < 0.01). The changes in BCFVA, BCNVA, MRS, and CS were significantly correlated with the amount of change in CMT (p < 0.007; r = 0.415, 0.528, -0.465, and -0.508, respectively). MRS exhibited a percentage change that was significantly correlated with that in CMT (p < 0.007; r = -0.511). Additionally, MRS exhibited the lowest threshold CMT (397 μm) at which the most significant change in improvement was observed. CMT was less likely to improve if BRVO occurred at a superior site than if it occurred at an inferior site (0.05 < p = 0.07 < 0.1). Conclusions MNREAD and CGS testing were useful for evaluating BRVO treatment efficacy. MRS might be a valuable index for evaluating treatment success and making treatment decisions.
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Affiliation(s)
- Hirotaka Tanabe
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Shizuoka, Japan
- * E-mail: (AO); (HT)
| | - Akira Obana
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Shizuoka, Japan
- * E-mail: (AO); (HT)
| | - Sachiko Yamamoto
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Shizuoka, Japan
| | - Kiyomi Ichikumi
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Shizuoka, Japan
| | - Yuko Gohto
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Shizuoka, Japan
| | - Takahiko Seto
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Shizuoka, Japan
| | - Takanobu Moriyama
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Shizuoka, Japan
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Radner W. Reading charts in ophthalmology. Graefes Arch Clin Exp Ophthalmol 2017; 255:1465-1482. [PMID: 28411305 PMCID: PMC5541099 DOI: 10.1007/s00417-017-3659-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 03/12/2017] [Accepted: 03/22/2017] [Indexed: 11/26/2022] Open
Abstract
A new generation of logarithmic reading charts has sparked interest in standardized reading performance analyses. Such reading charts have been developed according to the standards of the International Council of Ophthalmology. The print size progression in these calibrated charts is in accordance with the mathematical background of EN ISO 8596. These reading charts are: the Bailey–Lovie Word Reading Chart, the Colenbrander English Continuous Text Near Vision Cards, the Oculus Reading Probe II, the MNREAD Charts, the SKread Charts, and the RADNER Reading Charts. The test items used for these reading charts differ among the charts and are standardized to various extents. The Bailey–Lovie Charts, MNREAD Charts, SKread Charts, and RADNER Charts are also meant to measure reading speed and allow determination of further reading parameters such as reading acuity, reading speed based on reading acuity, critical print size, reading score, and logMAR/logRAD ratio. Such calibrated reading charts have already provided valuable insights into the reading performance of patients in many research studies. They are available in many languages and thus facilitate international communication about near visual performance. In the present review article, the backgrounds of these modern reading charts are presented, and their different levels of test-item standardization are discussed. Clinical research studies are mentioned, and a discussion about the immoderately high number of reading acuity notations is included. Using the logReading Acuity Determination ([logRAD] = reading acuity equivalent of logMAR) measure for research purposes would give reading acuity its own identity as a standardized reading parameter in ophthalmology.
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Affiliation(s)
- W Radner
- Austrian Academy of Ophthalmology, Mollgasse 11, 1180, Vienna, Austria.
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Gilaie-Dotan S, Doron R. Developmental visual perception deficits with no indications of prosopagnosia in a child with abnormal eye movements. Neuropsychologia 2017; 100:64-78. [PMID: 28400326 DOI: 10.1016/j.neuropsychologia.2017.04.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 04/03/2017] [Accepted: 04/07/2017] [Indexed: 11/19/2022]
Abstract
Visual categories are associated with eccentricity biases in high-order visual cortex: Faces and reading with foveally-biased regions, while common objects and space with mid- and peripherally-biased regions. As face perception and reading are among the most challenging human visual skills, and are often regarded as the peak achievements of a distributed neural network supporting common objects perception, it is unclear why objects, which also rely on foveal vision to be processed, are associated with mid-peripheral rather than with a foveal bias. Here, we studied BN, a 9 y.o. boy who has normal basic-level vision, abnormal (limited) oculomotor pursuit and saccades, and shows developmental object and contour integration deficits but with no indication of prosopagnosia. Although we cannot infer causation from the data presented here, we suggest that normal pursuit and saccades could be critical for the development of contour integration and object perception. While faces and perhaps reading, when fixated upon, take up a small portion of central visual field and require only small eye movements to be properly processed, common objects typically prevail in mid-peripheral visual field and rely on longer-distance voluntary eye movements as saccades to be brought to fixation. While retinal information feeds into early visual cortex in an eccentricity orderly manner, we hypothesize that propagation of non-foveal information to mid and high-order visual cortex critically relies on circuitry involving eye movements. Limited or atypical eye movements, as in the case of BN, may hinder normal information flow to mid-eccentricity biased high-order visual cortex, adversely affecting its development and consequently inducing visual perceptual deficits predominantly for categories associated with these regions.
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Affiliation(s)
- Sharon Gilaie-Dotan
- Department of Optometry and Visual Science, Bar Ilan University, Ramat Gan, Israel; UCL Institute of Cognitive Neuroscience, London, UK.
| | - Ravid Doron
- Department of Optometry and Vision Science, Hadassah Academic College, Jerusalem, Israel; Goldschleger Eye Research Institute, Sackler Faculty of Medicine, Tel-A viv University, Tel-Hashomer, Israel
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Dysli M, Abegg M. Nystagmus Does Not Limit Reading Ability in Albinism. PLoS One 2016; 11:e0158815. [PMID: 27391149 PMCID: PMC4938398 DOI: 10.1371/journal.pone.0158815] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Accepted: 06/22/2016] [Indexed: 12/02/2022] Open
Abstract
Purpose Subjects with albinism usually suffer from nystagmus and reduced visual acuity, which may impair reading performance. The contribution of nystagmus to decreased reading ability is not known. Low vision and nystagmus may have an additive effect. We aimed to address this question by motion compensation of the nystagmus in affected subjects and by simulating nystagmus in healthy controls. Methods Reading speed and eye movements were assessed in 9 subjects with nystagmus associated with albinism and in 12 healthy controls. We compared the reading ability with steady word presentation and with words presented on a gaze contingent display where words move in parallel to the nystagmus and thus correct for the nystagmus. As the control, healthy subjects were asked to read words and texts in steady reading conditions as well as text passages that moved in a pattern similar to nystagmus. Results Correcting nystagmus with a gaze contingent display neither improved nor reduced the reading speed for single words. Subjects with nystagmus and healthy participants achieved comparable reading speed when reading steady texts. However, movement of text in healthy controls caused a significantly reduced reading speed and more regressive saccades. Conclusions Our results argue against nystagmus as the rate limiting factor for reading speed when words were presented in high enough magnification and support the notion that other sensory visual impairments associated with albinism (for example reduced visual acuity) might be the primary causes for reading impairment.
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Affiliation(s)
- Muriel Dysli
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- * E-mail:
| | - Mathias Abegg
- Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Udeh NN, Eze BI, Onwubiko SN, Arinze OC, Onwasigwe EN, Umeh RE. Prevalence and profile of ophthalmic disorders in oculocutaneous albinism: a field report from South-Eastern Nigeria. J Community Health 2016; 39:1193-9. [PMID: 24806601 DOI: 10.1007/s10900-014-9878-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
To assess the burden and spectrum of refractive and non-refractive ophthalmic disorders in south-eastern Nigerians with oculocutaneous albinism. In a population-based survey in Enugu state, between August, 2011 and January, 2012, albinos were identified using the database of the Enugu state's Albino Foundation, and mass media-based mobilisation. The participants were enrolled at the Eye Clinics of the University of Nigeria Teaching Hospital and Enugu State University of Science and Technology Teaching Hospital using a defined protocol. Relevant socio-demographic and clinical data were obtained from each participant. Descriptive and comparative statistics were performed. Statistical significance was indicated by p < 0.05. The participants (n = 153; males, 70) were aged 23.5 + 10.4 SD years (range 6-60 years). Both refractive and non-refractive disorders were present in all participants. Non-refractive disorders comprised nystagmus, foveal hypoplasia, hypopigmented fundi and prominent choroidal vessels in 100.0% participants; and strabismus in 16.3% participants. Refractive disorders comprised astigmatism -73.2% eyes, myopia -23.9% and hypermetropia 2.9%. Spherical refractive errors ranged from -14.00 DS to +8.00 DS while astigmatic errors ranged from -6.00 DC to +6 DC. Mixed refractive and non-refractive disorder i.e. presenting visual impairment was present in 100.0% participants. Overall, refractive error was associated with non-possession of tertiary education (OR 0.61; 95% CI 0.38-0.96; p = 0.0374). There is high prevalence of refractive, non-refractive and mixed ophthalmic disorders among albinos in south-eastern Nigeria. This underscores the need for tailored provision of resources to address their eye care needs, and creation of needs awareness amongst them.
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Affiliation(s)
- N N Udeh
- Department of Ophthalmology, University of Nigeria Teaching Hospital, Ituku-Ozalla, PMB 01139, Enugu, Nigeria
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Xu R, Bradley A. IURead: a new computer-based reading test. Ophthalmic Physiol Opt 2015; 35:500-13. [PMID: 26303446 DOI: 10.1111/opo.12233] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 07/06/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE To develop a computer-based single sentence reading test especially designed for clinical research enabling multiple repeat trials without reusing the same sentences. METHODS We initially developed 422 sentences, with an average of 60 characters and 12 words. Presentation controls were improved by employing computer-based testing and the oral reading was recorded by visual inspection of digital audio recordings. Variability in reading speed of normally sighted adults between sentences, between charts, between subjects, between formats, and between display devices was quantified. The impact of display size and pixel resolution on test geometry was assessed, and the impact of reduced retinal image quality and retinal illuminance were compared for reading and standard letter acuities. Eleven visually normal subjects (age: 18-60 years) participated in this study. RESULTS Stopwatch timing of sentences reliably underestimated reading times by about 0.3 s, and exhibited coefficients of repeatability 17 times larger than those estimated from visual inspection of digital recordings. A slight relaxing of the lexical content constraints had no effect on reading speed; neither did sentence format (single vs three lines) or display size or distance. Within subject standard deviations of reading speed for different sentences were small (between 6% and 9% of the mean speed) requiring only small samples sizes to achieve typical statistical reliability and power when comparing conditions within individual subjects. The greater variability associated with stopwatch timing necessitates larger sample sizes. As defocus and light level were varied, reading acuity and standard letter acuity were highly correlated (r(2) = 0.99), and reading acuity was slightly better. DISCUSSION A computer-based IURead reading test provides a useful reading speed and reading acuity tool for clinical research involving multiple conditions and repeat testing of individual subjects. Ready to use IURead files for use with a computer, tablet or cell phone can be downloaded from our lab website (https://www.opt.indiana.edu/Bradley/Downloads.aspx).
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Affiliation(s)
- Renfeng Xu
- Indiana University School of Optometry, Bloomington, USA
| | - Arthur Bradley
- Indiana University School of Optometry, Bloomington, USA
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12
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Crowded visual search in children with normal vision and children with visual impairment. Vision Res 2014; 96:65-74. [DOI: 10.1016/j.visres.2014.01.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 01/09/2014] [Accepted: 01/10/2014] [Indexed: 11/18/2022]
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Huurneman B, Boonstra FN. Monocular and binocular development in children with albinism, infantile nystagmus syndrome, and normal vision. Strabismus 2013; 21:216-24. [PMID: 24195763 DOI: 10.3109/09273972.2013.833954] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND/AIMS To compare interocular acuity differences, crowding ratios, and binocular summation ratios in 4- to 8-year-old children with albinism (n = 16), children with infantile nystagmus syndrome (n = 10), and children with normal vision (n = 72). METHODS Interocular acuity differences and binocular summation ratios were compared between groups. Crowding ratios were calculated by dividing the single Landolt C decimal acuity with the crowded Landolt C decimal acuity mono- and binocularly. A linear regression analysis was conducted to investigate the contribution of 5 predictors to the monocular and binocular crowding ratio: nystagmus amplitude, nystagmus frequency, strabismus, astigmatism, and anisometropia. RESULTS Crowding ratios were higher under mono- and binocular viewing conditions for children with infantile nystagmus syndrome than for children with normal vision. Children with albinism showed higher crowding ratios in their poorer eye and under binocular viewing conditions than children with normal vision. Children with albinism and children with infantile nystagmus syndrome showed larger interocular acuity differences than children with normal vision (0.1 logMAR in our clinical groups and 0.0 logMAR in children with normal vision). Binocular summation ratios did not differ between groups. Strabismus and nystagmus amplitude predicted the crowding ratio in the poorer eye (p = 0.015 and p = 0.005, respectively). The crowding ratio in the better eye showed a marginally significant relation with nystagmus frequency and depth of anisometropia (p = 0.082 and p = 0.070, respectively). The binocular crowding ratio was not predicted by any of the variables. CONCLUSIONS Children with albinism and children with infantile nystagmus syndrome show larger interocular acuity differences than children with normal vision. Strabismus and nystagmus amplitude are significant predictors of the crowding ratio in the poorer eye.
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Affiliation(s)
- Bianca Huurneman
- Behavioural Science Institute, Radboud University Nijmegen , Nijmegen, The Netherlands
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Barot N, McLean RJ, Gottlob I, Proudlock FA. Reading performance in infantile nystagmus. Ophthalmology 2013; 120:1232-8. [PMID: 23462273 DOI: 10.1016/j.ophtha.2012.11.032] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 11/15/2012] [Accepted: 11/15/2012] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE 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. DESIGN Prospective cross-sectional study. PARTICIPANTS AND CONTROLS Seventy-one participants with IN (37 idiopathic, 34 with albinism) and 20 age-matched controls. METHODS 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. MAIN OUTCOME MEASURES 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). RESULTS 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. CONCLUSIONS 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. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Niraj Barot
- Ophthalmology Group, Faculty of Medicine & Biological Sciences, University of Leicester, Leicester Royal Infirmary, Leicester, United Kingdom
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MacDonald JT, Kutzbach BR, Holleschau AM, Wyckoff S, Summers CG. Reading skills in children and adults with albinism: the role of visual impairment. J Pediatr Ophthalmol Strabismus 2012; 49:184-8. [PMID: 22074358 DOI: 10.3928/01913913-20111101-03] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Accepted: 09/14/2011] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate whether visual impairment in albinism contributes significantly to the acquisition of normal reading skills. METHODS The authors administered standardized reading tests to 41 children and 18 adults with albinism. The Young Children's Achievement Test was used for children between 4 and 6 years old and the Woodcock-Johnson III was used for children 7 years and older and adults. Parents of children and adult subjects also completed a questionnaire to document developmental, academic, and/or work experiences. The Spearman test was used to evaluate the relationship between binocular best-corrected visual acuity (BCVA) and reading test results. RESULTS Standardized reading tests in both children and adults with albinism showed a normal distribution of scores. BCVA did not appear to play a significant role in the development of normal reading ability in these individuals who were visually impaired except for a mild correlation of decreased reading fluency on the Woodcock-Johnson III with decreased BCVA (r = 0.287, P = .046). Many young children with albinism had superior reading skills despite having a BCVA of 20/200 or worse (legal blindness). CONCLUSION This study of cognitively normal children and adults with albinism demonstrates that impaired vision during childhood does not by itself significantly impede a child's ability to acquire normal reading skills. However, the lower reading fluency that occurs in the more visually impaired individuals suggests they would benefit, both in the school system and workplace, with an accommodation involving more time to complete reading tasks.
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Affiliation(s)
- John T MacDonald
- Department of Neurology, Division of Clinical Pediatric Neuroscience, University of Minnesota, 420 Delaware Street S.E., Minneapolis, MN 55455, USA.
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Brown SM. Appropriate research design for studies of refractive surgery in children. J Cataract Refract Surg 2011; 37:1379-81. [PMID: 21782082 DOI: 10.1016/j.jcrs.2011.06.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Brooks BP. Making progress in albinism. J AAPOS 2011; 15:1-2. [PMID: 21397796 DOI: 10.1016/j.jaapos.2011.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2011] [Accepted: 01/14/2011] [Indexed: 11/25/2022]
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