Learning to read vertical text in peripheral vision

Customizing spatial remapping of letters to aid reading in the presence of a simulated central field loss

Reading is a primary concern of patients with central field loss (CFL) because it is typically performed with foveal vision. Spatial remapping offers one potential avenue to aid in reading; it entails shifting occluded letters to retinal areas where vision is functional. Here, we introduce a method of creating and testing different remapping strategies-ways to remap text-customized for CFL of different shapes. By simulating CFL in typically-sighted individuals, we tested the customization hypothesis-that the benefits of different remapping strategies will depend on the properties of the CFL. That is, remapping strategies will aid reading differentially in the presence of differently shaped CFL. In Experiment 1, letter recognition in the presence of differently shaped CFL was assessed in and around central vision. Using these letter recognition "maps" different spatial remappings were created and tested in Experiment 2 using a word recognition task. Results showed that the horizontal gap remapping, which did not remap any letters vertically, resulted in the best word recognition. Results were also consistent with the customization hypothesis; the benefits of different remappings on word recognition depended on the different CFL shapes. Although the horizontal gap remapping resulted in very good word recognition, tailoring remapping strategies to the shape of patients' CFL may aid reading with the wide range of sizes and shapes encountered by patients with CFL.

Vertical and horizontal reading training in patients with hemianopia and its effect on reading eye movements

Vertical reading training (VRTr) increases reading speed (RS) significantly in patients with hemianopic field defects (HFD). We ask, how eye movements (EM) contribute to this improvement and whether EM-behavior is affected by the side of HFD. Twenty-one patients, randomly assigned to VRTr or horizontal RTr, trained reading single lines from a screen at home, for 4 weeks. In the clinic, we recorded EM while reading short sentences aloud from a screen before training (T1), directly (T2) and 4 weeks afterwards (T3). RS-screen was correlated with RS during reading printed paragraphs (RS-print) to assess the transfer to everyday life. RS-screen and RS-print correlated positively (horizontal: r > 0.8, vertical: r > 0.9) at all times. Vertical RS did not exceed horizontal RS. We found significant negative correlations of EM-variables and RS-print: in right-HFD with the number of forward saccades (T1: r =  - 0.79, T2: r =  - 0.94), in left-HFD with the steps during return sweeps (T1: r =  - 0.83, T2: r =  - 0.56). Training effects remained stable at T3. EM-improvement was specific for the RTr and the side of the HFD: in right-HFD fewer forward saccades after VRTr, in left-HFD fewer steps during return sweeps after HRTr. RTr on a screen transfers to reading printed text in real-life situations.Trial registration: The study was retrospectively registered in the German Clinical Trials register: DRKS-ID: DRKS00018843, March 13th, 2020.

Training peripheral vision to read: Using stimulus exposure and identity priming

Reading in the periphery can be improved with perceptual learning. A conventional training paradigm involves repeated practice on a character-based task (e.g., recognizing random letters/words). While the training is effective, the hours of strenuous effort required from the trainees makes it difficult to implement the training in low-vision patients. Here, we developed a training paradigm utilizing stimulus exposure and identity priming to minimize training effort and improve training accessibility while maintaining the active engagement of observers through a stimulus visibility task. Twenty-one normally sighted young adults were randomly assigned to three groups: a control group, a with-repetition training group, and a without-repetition training group. All observers received a pre-test and a post-test scheduled 1 week apart. Each test consisted of measurements of reading speed, visual-span profile, the spatial extent of crowding, and isolated-letter profiles at 10° eccentricity in the lower visual field. Training consists of five daily sessions (a total of 7,150 trials) of viewing trigram stimuli (strings of three letters) with identity priming (prior knowledge of target letter identity). The with-repetition group was given the option to replay each stimulus (averaged 0.4 times). In comparison to the control group, both training groups showed significant improvements in all four performance measures. Stimulus replay did not yield a measurable benefit on learning. Learning transferred to various untrained tasks and conditions, such as the reading task and untrained letter size. Reduction in crowding was the main basis of the training-related improvement in reading. We also found that the learning can be partially retained for a minimum of 3 months and that complete retention is attainable with additional monthly training. Our findings suggest that conventional training task that requires recognizing random letters or words is dispensable for improving peripheral reading. Utilizing stimulus exposure and identity priming accompanied by a stimulus visibility task, our novel training procedure offers effective intervention, simple implementation, capability for remote and self-administration, and an easy translation into low-vision reading rehabilitation.

Morpheme Transposition of Two-Character Chinese Words in Vertical Visual Fields

The present study explored the morpheme transposition process of two-character Chinese words in the upper and lower visual fields by adopting a dual-target rapid serial visual presentation paradigm. The results showed that the identification accuracy of canonical words was better in the lower visual field, whereas the accuracy of transposed words was almost identical in the upper and lower visual fields. Furthermore, there was no significant difference between canonical and transposed words at 0°, 2°, 4°, and 6° eccentricities in the upper visual field. However, the accuracy of canonical words was markedly higher than that of transposed words at 2°, 4°, and 6° eccentricities in the lower visual field. Finally, the character order errors mainly occurred at 0°eccentricity with a duration of 100 ms in vertical visual fields. These findings, taken together, indicated that the character transposition affected the lexical process of two-character Chinese words in the lower visual field but not in the upper visual field, and the character order of words was more likely to be reversed at 0° eccentricity and the initial stage of visual word processing in vertical reading.

Training of vertical versus horizontal reading in patients with hemianopia - a randomized and controlled study

HYPOTHESIS

Patients with hemianopic field defects (HFD) might benefit from reading text in vertical orientation if they place the text in the seeing hemifield along the vertical midline.

METHODS

We assigned 21 patients with HFD randomly to either vertical or horizontal reading training. They trained reading single lines of texts from a computer screen at home for 2 × 30 min/day, 5 days/week, for 4 weeks. The main outcome variable was reading speed (RS) during reading standardized paragraphs of printed text (IReST) aloud. RS was assessed before training (T1), directly after training (T2) and 4 weeks later (T3). Quality of life (QoL) was assessed by Impact of Visual Impairment (IVI) questionnaire.

RESULTS

Vertical training improved RS in the vertical direction significantly. Only patients with right HFD benefited. Horizontal training improved RS in horizontal diection significantly, but much more in patients with left than in those with right HFD. Both effects remained stable at T3. RS during training at the computer improved highly significantly and correlated strongly with RS of printed text (Pearson r= > 0.9). QoL: Vertical training showed a statistically significant improvement in the complete IVI-score, patients with right HFD in the emotional IVI-score.

CONCLUSIONS

The improvements of RS were specific for the training. The stable effect indicates that the patients can apply the newly learned strategies to everyday life. The side of the HFD plays an essential role: Left-HFD patients benefitted from horizontal training, right-HFD patients from vertical training. However, the vertical RS did not reach the level of horizontal RS. The study was registered in the German Clinical Trials register (DRKS-ID: DRKS00018843).

How Does Vertical Reading Affect Reading Speed?

PURPOSE

Vertical reading is an adaptive reading strategy sometimes used in homonymous hemianopia. This study aimed to measure horizontal and vertical reading speeds in visually normal volunteers using the Radner Reading Chart.

METHODS

Fifteen orthoptic students, mean age 19.7 years, took part in this repeated measures study. Participants read sentences aloud from the Radner Reading Chart horizontally and rotated vertically, to read up and down the line. Words read correctly and the time taken to read each sentence were recorded.

RESULTS

Reading speeds were calculated (words read correctly per second) for horizontal text (2.95 words per second) and for vertical text, reading up the line (1.73 words per second) and reading down the line (1.57 words per second). Reading horizontal text was significantly faster than reading vertical text. Reading horizontal text was 1.22 words per second faster than reading text vertically up (p < 0.0001) and 1.38 words per second faster than text vertically down (p < 0.0001). There was no statistically significant difference between reading text vertically up the line and vertically down the line (0.16 words per second, p = 0.42).

CONCLUSION

Horizontal reading speed, measured with the Radner Reading Chart, was significantly faster than both vertical reading speeds. There was no significant difference between reading vertically up the line and reading vertically down the line. The slower time taken to read the vertically orientated sentences had a greater effect on reading speed than the number of errors made.

Baseline MNREAD Measures for Normally Sighted Subjects From Childhood to Old Age

Purpose

The continuous-text reading-acuity test MNREAD is designed to measure the reading performance of people with normal and low vision. This test is used to estimate maximum reading speed (MRS), critical print size (CPS), reading acuity (RA), and the reading accessibility index (ACC). Here we report the age dependence of these measures for normally sighted individuals, providing baseline data for MNREAD testing.

Methods

We analyzed MNREAD data from 645 normally sighted participants ranging in age from 8 to 81 years. The data were collected in several studies conducted by different testers and at different sites in our research program, enabling evaluation of robustness of the test.

Results

Maximum reading speed and reading accessibility index showed a trilinear dependence on age: first increasing from 8 to 16 years (MRS: 140–200 words per minute [wpm]; ACC: 0.7–1.0); then stabilizing in the range of 16 to 40 years (MRS: 200 ± 25 wpm; ACC: 1.0 ± 0.14); and decreasing to 175 wpm and 0.88 by 81 years. Critical print size was constant from 8 to 23 years (0.08 logMAR), increased slowly until 68 years (0.21 logMAR), and then more rapidly until 81 years (0.34 logMAR). logMAR reading acuity improved from −0.1 at 8 years to −0.18 at 16 years, then gradually worsened to −0.05 at 81 years.

Conclusions

We found a weak dependence of the MNREAD parameters on age in normal vision. In broad terms, MNREAD performance exhibits differences between three age groups: children 8 to 16 years, young adults 16 to 40 years, and middle-aged to older adults >40 years.

Does Vertical Reading Help People with Macular Degeneration: An Exploratory Study

Individuals with macular degeneration often develop a Preferred Retinal Locus (PRL) used in place of the impaired fovea. It is known that many people adopt a PRL left of the scotoma, which is likely to affect reading by occluding text to the right of fixation. For such individuals, we examined the possibility that reading vertical text, in which words are rotated 90° with respect to the normal horizontal orientation, would be beneficial for reading. Vertically oriented words would be tangential to the scotoma instead of being partially occluded by it. Here we report the results of an exploratory study that aimed at investigating this hypothesis. We trained individuals with macular degeneration who had PRLs left of their scotoma to read text rotated 90° clockwise and presented using rapid serial visual presentation (RSVP). Although training resulted in improved reading of vertical text, the training did not result in reading speeds that appreciably exceeded reading speeds following training with horizontal text. These results do not support the hypothesis that people with left PRLs read faster with vertical text.

Low Vision and Plasticity: Implications for Rehabilitation

Low vision is any type of visual impairment that affects activities of daily living. In the context of low vision, we define plasticity as changes in brain or perceptual behavior that follow the onset of visual impairment and that are not directly due to the underlying pathology. An important goal of low-vision research is to determine how plasticity affects visual performance of everyday activities. In this review, we consider the levels of the visual system at which plasticity occurs, the impact of age and visual experience on plasticity, and whether plastic changes are spontaneous or require explicit training. We also discuss how plasticity may affect low-vision rehabilitation. Developments in retinal imaging, noninvasive brain imaging, and eye tracking have supplemented traditional clinical and psychophysical methods for assessing how the visual system adapts to visual impairment. Findings from contemporary research are providing tools to guide people with low vision in adopting appropriate rehabilitation strategies.