Evaluation of Reading Performance and Visual Acuity Tests

Abstract

Improving reading ability is of high priority for most patients visiting optometric practice. Thus, it is expected that reading performance is one of the most important outcome measures for judging reading ability and the effectiveness of ocular interventions. Measuring near and distance visual acuity are simple and quick, but they cannot predict reading acuity, reading speed and critical print size which better reflect real-life reading performance. In contrast to distance visual acuity charts, there is not yet agreement on the best test to evaluate reading performance. There are many reading test charts available.Reading test charts should be equally reliable. However, the work described in this thesis has shown that using different reading test charts, such as Radner, MNread, Colenbrander, Bailey-Lovie and IReST, resulted in different reading performance metrics. There are no studies that have undertaken a direct comparison between all these reading tests, hence in this thesis test-retest and inter-chart reliability of the reading test charts has been compared for pre-presbyopic, presbyopic and cataract subjects. Although the reading test charts presented in this thesis are considered as standardized tests in terms of the test item, the reliability results vary and can be classified as poor, acceptable and very good.Using a reliable reading chart to evaluate the efficacy of the presbyopia treatment is a useful tool to investigate the reading performance rather than isolated letter near visual acuity. Automated measurement of the reading performance metrics by using a computer-based reading test could overcome the variation of the results between the practitioners but needs to be further calibrated. The findings of this thesis have a number of important implications for current and future ophthalmic practice.