Low vision reading with sequential word presentation.

Individuals with scotomas in the center of their visual fields usually read much more slowly than visually impaired individuals without central scotomas. This study determines the extent to which inefficient eye movements could account for this difference. Using a technique described previously [Rubin and Turano (1992) Vision Research, 32, 895-902] text was presented sequentially, one word at a time at the same location in the visual field. Reading performance for rapid serial visual presentation (RSVP) was compared to conventional text presentation (PAGE) in 14 subjects with dense central scotomas (central field loss, CFL) and 9 without central scotomas (noCFL). Reading rates were faster with RSVP compared to PAGE, but CFL subjects improved less (by a factor of 1.5 +/- 0.41) than noCFL subjects (by a factor of 2.1 +/- 0.38). When reading rate (words/min) was converted to average word duration (msec/word) the reduction in word duration for RSVP compared to PAGE text averaged 150 msec for normal subjects, 171 msec for noCFL subjects, and 250 msec for CFL subjects. We hypothesized that the reduction in word duration was attributable to a reduced number of saccades/word. We confirmed this hypothesis by measuring the number of saccades during RSVP and PAGE reading using a scanning laser ophthalmoscope in four subjects with CFL. All of the subjects made fewer saccades during RSVP than PAGE reading (average reduction = 1.3 +/- 0.5 saccades/word). But even with the reduced number of saccades, CFL subjects required longer word durations than noCFL subjects. These results indicate that inefficient eye movements account for only part of the reduction in reading speed caused by CFL. An additional and potentially more important factor is the limited rate at which peripheral retina can perform the pattern decoding tasks required for reading.