Abstract
Purpose :
Individuals with glaucoma have impairments in reading speed and comprehension. We hypothesize that single word presentation as compared to paragraph presentation will improve reading comprehension in glaucoma by reducing the need for scanning the text and decreased crowding.
Methods :
Participants with primary glaucoma (age ≥18 years, better eye visual acuity (VA) ≥ 20/40, and reliable reproducible Humphrey visual fields (HVF) within 1 year were recruited from the Emory Eye clinic. All participants completed the Discourse Comprehension Test (DCT), a validated reading comprehension task that assesses reader’s comprehension and retention of main ideas and details from 2 homogenous sets of five paragraphs followed by 8 yes/no comprehension queries with a maximum score of 40. One set was presented as a paragraph (para-DCT) on a computer at font 22, the other set was presented on the computer one word at a time (single-DCT) at 70-120 words per minute. Subjects alternated between para-DCT and single-DCT. Reading speed was measured in para-DCT. Additionally, we collected Montreal Cognitive Assessment (MoCA) scores, better eye logMAR VA (calculated from Snellens VA), binocular visual field index (VFI- calculated from monocular HVF).
Results :
We included 11 glaucoma patients (age 70±9 yrs, 81.8% White, 45.5% female, reading speed 320±224 seconds, MoCA 25±5, VFI 84±22, VA 0.04±0.1). One outlier was excluded from the analysis (fig 1). Subjects with glaucoma performed better on the single-DCT as compared to para-DCT presentation (35±3 vs 32±4, paired t test p=0.006). Multiple linear regression was used to test if age, race, gender, MOCA, visual acuity, reading speed and total VFI significantly predicted differences between para-DCT and single-DCT. The overall regression was significant (p=0.015) with significant predictors being age (β = 0.8, p=0.007), MOCA (β=0.97, p=0.041), visual acuity in better eye (β=2.7, p=0.024) and total VFI (β=2.5, p=0.028). Race and gender were not significant.
Conclusions :
Individuals with glaucoma, particularly if they are older, have good cognitive ability, and have compromised peripheral vision, will improve their reading comprehension with the single word presentation as opposed to a standard paragraph presentation.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.