Psychophysics of reading: Clinical predictors of low-vision reading speed

Clinicians need to estimate how well their low-vision patients will perform everyday visual tasks such as reading or driving. Typically, it is not practical to measure task performance directly or to administer a lengthy series of special tests. Recent laboratory research has suggested that some routine clinical data may be useful in predicting reading performance. The purpose of the present study was to determine whether a promising set of simple measures-Snellen acuity, status of the central fields and ocular media, diagnosis, and age-could be used in a clinical setting to predict reading speed. One hundred and forty one patients who entered the low-vision clinic of the Minneapolis Society for the Blind received thorough eye examinations and a test of reading speed. Snellen acuity accounted for only 10% of the variance in reading speeds overall, but played a more important role for subjects with central loss. Age was a better predictor than acuity. A diagnosis of age-related maculopathy predicted slower reading speed than other causes of central-field loss, but the difference was attributed to age. Media status (clear or cloudy) had no predictive value. Our set of clinical predictors accounted for only about 30% of the variance in low-vision reading speeds. While data from more detailed visual testing might improve prediction, nonvisual factors such as age probably also contribute to the variance. Rather than relying on predictions from visual testing, clinical assessment of low-vision reading may be accomplished most easily with a suitably designed reading test.