Electronic Reading Devices Increase Reading Speed and Comfort in Patients with Moderate Vision Loss Daniel B. Roth, Henry L. Feng, Kunjal K. Modi, Howard F. Fine, Jonathan L. Prenner Retina Vitreous Center - Robert Wood Johnson Medical School, New Brunswick, New Jersey The authors have no financial interest in the subject matter of the presentation. BACKGROUND RESULTS Apple iPad 2 yields most improvement in reading speed in low-vision patients Visual ability is often weighted heavily on distance visual acuity. However, near-vision tasks, such as such as reading a book, are imperative for day-to-day functioning. Patients with mild-to-moderate visual impairment often complain about difficulty with near-vision tasks, severely impacting their functioning and quality of life. For near vision reading, increased illumination of the object has been shown to allow for better visualization and reading ability. Our prior research showed that visual ability measured by the illuminated iPhone Near Vision chart improved reading ability compared to a Rosenbaum Near card by 1 line of vision. It is unclear whether different mediums of reading, for example electronic devices, can lead to increased reading speed and comfort. Part A: Newspaper Reading Speed Study Patients with Visual Acuity of 20/20-20/25 preferred reading newspaper Patients with Visual Acuity of 20/30-20/40 preferred reading printed material Patients with Visual Acuity of 20/50-20/80 preferred reading on the iPad2 Reading speed was 114.4 WPM for newspaper, 118.4 WPM for Print, 127.8 WPM for iPad2 Printed material was read more quickly than newspaper (p=0.02) but iPad2 was read more quickly than both newspaper or print (p < 0.001). Poor visual acuity was correlated with a slower reading speed, but improvement in reading speed on the iPad2 was found at ALL levels of visual acuity. Patient’s reading speed increased significantly on the iPad2 when the font was magnified to 18 point (p<0.001). Part B: Electronic Device Study Reading speed was 186.7 WPM for book, 195.8 WPM for Kindle (12), 199.2 WPM for Kindle (18), 224.3 WPM for iPad2 (12), and 229.1 WPM for iPad2 (18). Patients had faster reading times for iPad2 when compared to a printed book or non- illuminated Amazon Kindle on ALL levels of visual acuity. Patients with Visual Acuity of 20/20-20/25 did show improvement in reading speed when using the iPad2, however it was the least significant. Patients with Visual Acuity of 20/40-20/200 showed the greatest improvement in reading speed when using the iPad2. Patient’s reading speed increased significantly on the iPad2 when the font was magnified to 18 point (p<0.001). PURPOSE To evaluate the ability of electronic devices to enhance reading speed and comfort in patients with compromised visual acuity, and to assess how a back-illuminated device (Apple iPad2) would compare to a non-illuminated device (Amazon Kindle) and a book. MATERIALS AND METHODS Part A – Patients were tested with regard to their reading speed and comfort with three different articles from The New York Times. They were randomly assigned one article from the newspaper version of The New York Times, another article from the same day printed from the on-line version of The New York Times, and a third article from the iPad2 version of The New York Times. All articles had a similar font size of 10 points. The reading speed was calculated in WPM (words per minute) after reading for 2 minutes. The reading speed was correlated with the visual acuity, and presence or absence of macular disease, as well as the specific type of macular disease. Patients were asked which type of reading material that they preferred. CONCLUSIONS Back illuminated devices, such as the iPad, increase patient reading speed. This improvement was greatest among patients with worse visual acuity. Patient reading speed was significantly increased when reading on the iPad2 (128 WPM), as compared with newspaper (114 WPM) or printed material (118 WPM). Patient reading speech was significantly increased when reading on the iPad2 compared to the Amazon Kindle, an electronic reading device that is not back-illuminated, or a book. Reading speed was further increased when magnifying the font on the iPad2. Part B – Patients were tested for reading speed and comfort by using five different chapters from a text. They were randomly assigned to read each chapter using a different medium: printed book, Apple iPad2 at 12 point font, Apple iPad2 at 18 point font, Amazon Kindle at 12 point font, and Amazon Kindle at 18 point font. The Apple iPad 2 was set at maximum background illumination. The reading speech was calculated in WPM (words per minute) after reading for 1 minute. The reading speed was correlated with the visual acuity, and presence or absence of macular disease, as well as the specific type of macular disease. Patients were asked which type of reading material that they preferred. BIBLIOGRAPHY Falkenstein IA, Cochran DE, Azen SP, et al. Comparison of Visual Acuity in Macular Degeneration Patients Measured with Snellen and Early Treatment Diabetic Retinopathy Study Charts. Ophthalmology 2008; 115:319-323. Elliot DB, Patel B, Whitaker D. Development of a Readng Speed Test for Potential- Vision Measurements. Invest Ophthalmol Vis Sci. 2001; 42:1945-1949. DeCas R, Street DA, Javitt JC. Assessment of Visual Acuity via a Telephone Interview. Arch Ophthalmol. 1992;110(9):1279-82.`