Comparing Reading Speeds for Reading Standardized Single Sentences and Paragraphs in Patients with Maculopathy

Comparing silent reading performance for single sentences and paragraphs: an eye movement-based analysis

CLINICAL RELEVANCE

Reading performance in clinical practice is commonly evaluated by reading 'aloud' and 'as fast as possible' single sentences. Assessing comprehensive silent reading performance using passages, composed of multiple sentences, is the preferred reading mode in real-life reading conditions.

BACKGROUND

The purpose of this study was to compare eye movement-based silent reading performance for standardised short sentences and paragraphs.

METHODS

A group of 15 young volunteers (age range: 22-36 years) read silently and comprehensively in two sessions: (a) a paragraph with continuous text and (b) standardised short sentences. Text print size was 0.4 logMAR (1.0 M at 40 cm distance). Eye movements during reading were recorded using video oculography (EyeLink II, SR Research Ltd). Data analysis included computation of reading speed, fixation duration, the number of fixations, saccadic amplitude and percentage of regressions. Moreover, frequency distributions of fixation durations were analysed with ex-Gaussian fittings.

RESULTS

Repeatability coefficient in silent reading speed was found better for the paragraph (66 wpm) than for short sentences (88 wpm). The superiority in repeatability coefficient for the corresponding eye movement parameters, i.e. fixation duration (35 vs 73 ms), regressions (10.1 vs. 22.3%) and fixations per word (0.21 vs. 0.37 fpw), was even more pronounced. In addition, a statistically significant improvement with the paragraph was found in average fixation duration (19 ± 26 ms, p = 0.02), regressions (4.2 ± 7.0%, p = 0.04) and ex-Gaussian fixation parameter, τ (82 vs. 111 ms). No statistically significant difference was found between average reading speed with the paragraph (220 ± 59 wpm) and the short sentences (206 ± 57 wpm) (p = 0.11).

DISCUSSION

Due to their superior repeatability, paragraphs are preferable to short sentences when evaluating silent comprehensive reading. The concurrent recording of eye movement parameters in silent reading further improves variability and could offer an efficient measure of reading performance and a reliable biomarker of visuo-motor function.

Reading Difficulties in Individuals with Homonymous Visual Field Defects: A Systematic Review of Reported Interventions

Reading difficulties are amongst the most commonly reported problems in individuals with homonymous visual field defects (HVFDs). To be able to provide guidance for healthcare professionals considering offering reading training, researchers in this field and interested individuals with HVFDs, this systematic review aims to (1) provide an overview of the contextual and intervention characteristics of all published HVFD interventions and (2) generate insights into the different reading outcome measures that these studies adopted. A search on PsycINFO, MEDLINE and Web of Science was conducted up to February 2, 2023. All intervention studies for HVFD in which reading was measured were included. Data was collected about the intervention type, session duration, number of sessions, the intensity, duration, circumstance of the interventions, country in which the intervention was studied and reading measures. Sixty records are included, describing 70 interventions in total of which 21 are specifically reading interventions. Overall, adjusted saccadic behaviour interventions occur most in the literature. A wide range within all intervention characteristics was observed. Forty-nine records reported task-performance reading measures, and 33 records reported self-reported reading measures. The majority of task-performance measures are based on self-developed paragraph reading tasks with a time-based outcome measure (e.g. words per minute). Future research could benefit from making use of validated reading tests, approaching the measurement of reading mixed-methods and providing participants the possibility to supply outcomes relevant to them.

Altered Eye Movements During Reading With Simulated Central and Peripheral Visual Field Defects

Purpose

Although foveal vision provides fine spatial information, parafoveal and peripheral vision are also known to be important for efficient reading behaviors. Here we systematically investigate how different types and sizes of visual field defects affect the way visual information is acquired via eye movements during reading.

Methods

Using gaze-contingent displays, simulated scotomas were induced in 24 adults with normal or corrected-to-normal vision during a reading task. The study design included peripheral and central scotomas of varying sizes (aperture or scotoma size of 2°, 4°, 6°, 8°, and 10°) and no-scotoma conditions. Eye movements (e.g., forward/backward saccades, fixations, microsaccades) were plotted as a function of either the aperture or scotoma size, and their relationships were characterized by the best fitting model.

Results

When the aperture size of the peripheral scotoma decreased below 6° (11 visible letters), there were significant decreases in saccade amplitude and velocity, as well as substantial increases in fixation duration and the number of fixations. Its dependency on the aperture size is best characterized by an exponential decay or growth function in log-linear coordinates. However, saccade amplitude and velocity, fixation duration, and forward/regressive saccades increased more or less linearly with increasing central scotoma size in log-linear coordinates.

Conclusions

Our results showed differential impacts of central and peripheral vision loss on reading behaviors while lending further support for the importance of foveal and parafoveal vision in reading. These apparently deviated oculomotor behaviors may in part reflect optimal reading strategies to compensate for the loss of visual information.

Efficacy οf Wet Age-related Macular Degeneration Treatment οn Reading: A Pilot Study Using Eye-movement Analysis

SIGNIFICANCE

Functional vision, as evaluated with silent passage reading speed, improves after anti-vascular endothelial growth factor (anti-VEGF) treatment in patients with wet age-related macular antidegeneration (wAMD), reflecting primarily a concomitant reduction in the number of fixations. Implementing eye movement analysis when reading may better characterize the effectiveness of therapeutic approaches in wAMD.

PURPOSE

This study aimed to evaluate silent reading performance by means of eye fixation analysis before and after anti-VEGF treatment in wAMD patients.

METHODS

Sixteen wAMD patients who underwent anti-VEGF treatment in one eye and visual acuity (VA) better than 0.5 logMAR served as the AMD group. Twenty adults without ocular pathology served as the control group. Central retinal thickness and near VA were assessed at baseline and 3 to 4 months after their first visit. Reading performance was evaluated using short passages of 0.4-logMAR print size. Eye movements were recorded using EyeLink II video eye tracker. Data analysis included computation of reading speed, fixation duration, number of fixations, and percentage of regressions. Frequency distributions of fixation durations were analyzed with ex-Gaussian fittings.

RESULTS

In the AMD group, silent reading speed in the treated eye correlated well with central retinal thickness reduction and improved significantly by an average of 15.9 ± 28.5 words per minute (P = .04). This improvement was accompanied by an average reduction of 0.24 ± 0.38 in fixations per word (P = .03). The corresponding improvement in monocular VA was not statistically significant. Other eye fixation parameters did not change significantly after treatment. No statistically significant differences were found in the control group.

CONCLUSIONS

Visual acuity tests may underestimate the potential therapeutic effects after anti-VEGF treatment in patients with relatively good acuity who are being treated for wAMD. Evaluating silent reading performance and eye fixation parameters may better characterize the effectiveness of therapeutic approaches in wAMD patients.

Reading Speed Using the International Reading Speed Texts in a Normal Canadian Cohort

Background The International Reading Speed Texts (IReST) are commonly used to measure reading speed, which may be affected in many eye conditions. They were originally tested in a younger British population. Our study evaluates IReST in a normal Canadian population. Methodology A normal Canadian cohort in Ontario was prospectively recruited with age >14 years, education >9 years, English as the primary language, and best-corrected visual acuity >20/25 distance and >N8 near in each eye. Participants with eye conditions and neurological/cognitive problems were excluded. Each participant consecutively read two IReST passages (passages 1 and 8). Reading speed in words per minute (WPM) was calculated. One-sample t-test was used to compare our cohort to published IReST standards. Results A total of 112 participants were included (35 male, 77 female). The mean age was 40 ± 17 years (14-18 years: 12; 18-35 years: 34; 35-60 years: 53; 60-75 years: 13). The mean reading speed for passage 1 was 211 ± 33 WPM compared to the published IReST standard of 236 ± 29 WPM (p < 0.0001). The mean reading speed for passage 8 was 218 ± 34 WPM compared to the IReST standard of 237 ± 24 WPM (p < 0.0001). Thus, our cohort read slower for both passages compared to IReST standards. The mean reading speed for passages 1 and 8 was the highest for the 14-18-year (231 and 239, respectively) and the lowest for the 60-75-year group (195 and 192, respectively). Conclusions Normal older populations have slower reading compared to younger populations. The slower reading in our cohort may also be because the passages were in British rather than in Canadian English. It is important that the IReST is evaluated in different populations to ensure reliable comparison standards for future research.

The effects of simulated hemianopia on eye movements during text reading

Vision loss is a common, devastating complication of cerebral strokes. In some cases the complete contra-lesional visual field is affected, leading to problems with routine tasks and, notably, the ability to read. Although visual information crucial for reading is imaged on the foveal region, readers often extract useful parafoveal information from the next word or two in the text. In hemianopic field loss, parafoveal processing is compromised, shrinking the visual span and resulting in slower reading speeds. Recent approaches to rehabilitation using perceptual training have been able to demonstrate some recovery of useful visual capacity. As gains in visual sensitivity were most pronounced at the border of the scotoma, it may be possible to use training to restore some of the lost visual span for reading. As restitutive approaches often involve prolonged training sessions, it would be beneficial to know how much recovery is required to restore reading ability. To address this issue, we employed a gaze-contingent paradigm using a low-pass filter to blur one side of the text, functionally simulating a visual field defect. The degree of blurring acts as a proxy for visual function recovery that could arise from restitutive strategies, and allows us to evaluate and quantify the degree of visual recovery required to support normal reading fluency in patients. Because reading ability changes with age, we recruited a group of younger participants, and another with older participants who are closer in age to risk groups for ischaemic strokes. Our results show that changes in patterns of eye movement observed in hemianopic loss can be captured using this simulated reading environment. This opens up the possibility of using participants with normal visual function to help identify the most promising strategies for ameliorating hemianopic loss, before translation to patient groups.