Benefits of low vision aids to reading accessibility

The Reading Accessibility Index (ACC) has been proposed as a single-value reading parameter that can capture information on both reading speed and print sizes that can be read. It is defined as the average reading speed across a relevant range of print sizes (1.3-0.4logMAR), normalised by typical young-adult reading speed of 200wpm, and with values typically in the range of 0-1. This study determines the impact of low vision aids (LVAs) on reading by evaluating ACC values for visually impaired observers reading both without and with an optical LVA. A secondary analysis of previously published data obtained from 100 visually impaired observers attending low vision assessments was undertaken. Observers had mixed causes of visual impairment but predominantly macular degeneration (n=55). All used an LVA for reading, with 88% using it ‘often’ or ‘very often’. MNREAD reading parameters, including ACC, were determined both for reading without an LVA (clinical function) and with the LVA habitually used for reading (aided function). There was a significant (p<.001) improvement in ACC from clinical (0.31 (95% CI 0.25, 0.36)) to aided conditions (0.47 (0.41, 0.52)). Average improvement in ACC with an LVA was 0.16 (0.13, 0.18), but the benefits of LVAs in terms of improvement in ACC could not be predicted from clinical visual function. Even with an LVA reading accessibility is, on average, markedly reduced from normal levels. The ACC is a potentially valuable outcome measure for reading rehabilitation interventions.