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Patients who suffer from sight-threatening eye diseases share a desire to regain a comfortable reading ability. In light of the modern advances achieved in ophthalmic diagnosis and therapy, and because a significant lack of comparability between reading charts still exists, there is an increasing need for a worldwide standard in the form of a norm for diagnostic reading charts. Already, applied advancements such as digital print, which allow a calibration of the print sizes of reading charts in correctly progressing geometric proportions by using the actual height of a lower case "x" in millimeters (x-height), and psychophysically standardizing reading charts and their test items by applying modern statistical methods have significantly contributed to establishing a norm for reading charts. In 2020, a proposal of the British delegation was accepted by the International Organization for Standardization (ISO) group "Visual Optics and Optical Instruments," and a working group was established. Bearing in mind the efforts of the ISO with regard to an international norm, this review article is intended to (a) give an overview of the historical background and related normative approaches for diagnostic reading tests used in ophthalmology and optometry, (b) explain psychophysical and technical concerns, and (c) discuss the possibilities and limits of concepts that seem relevant to developing a modern standard for reading charts. • Modern reading charts can provide comprehensible and comparable investigations of reading acuity and speed. • Clinical research has established that modern standardized reading charts are superior to historic or conventional reading charts. • Comparability between reading charts can be best achieved by calibrating the print sizes with the x-height of a font. • Statistical standardization of reading charts and test items is indispensable as it provides known reproducibility, reliability and validity. • In light of modern advances in ophthalmic diagnosis and therapy, establishing an international norm for reading charts is necessary. [ABSTRACT FROM AUTHOR]

The MNREAD chart consists of standardized sentences printed at 19 sizes in 0.1 logMAR steps. There are 95 sentences distributed across the five English versions of the chart. However, there is a demand for a much larger number of sentences: for clinical research requiring repeated measures, and for new vision tests that use multiple trials at each print size. This paper describes a new sentence generator that has produced over nine million sentences that fit the MNREAD constraints, and demonstrates that reading performance with these new sentences is comparable to that obtained with the original MNREAD sentences. We measured reading performance with the original MNREAD sentences, two sets of our new sentences, and sentences with shuffled word order. Reading-speed versus print-size curves were obtained for each sentence set from 14 readers with normal vision at two levels of blur (intended to simulate acuity loss in low vision) and with unblurred text. We found no significant differences between the new and original sentences in reading acuity and critical print size across all levels of blur. Maximum reading speed was 7% slower with the new sentences than with the original sentences. Shuffled sentences yielded slower maximum reading speeds and larger reading acuities than the other sentences. Overall, measures of reading performance with the new sentences are similar to those obtained with the original MNREAD sentences. Our sentence generator substantially expands the reading materials for clinical research on reading vision using the MNREAD test, and opens up new possibilities for measuring how text parameters affect reading. [ABSTRACT FROM AUTHOR]

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Summary: Objective: Despite reported gaze stability deficits in children with hearing impairment and concurrent vestibular hypofunction, the reading difficulties reported in this population have not been linked to the gaze instability. The purpose of this study was to develop a modified version of the MNREAD chart that enabled responses orally or using sign language. Methods: Seventy-two typically developing children and 14 children with sensorineural hearing loss with and without vestibular hypofunction participated. We examined: (1) reliability and age related changes in reading acuity scores, (2) the effect of vestibular hypofunction on reading acuity scores, and (3) the relationship between these scores and a test of dynamic visual acuity. Results: The test was reliable (ICC (3,2)≥0.86). Reading acuity scores were significantly worse in children with vestibular hypofunction (p ≤0.002). Furthermore, reading acuity scores correlated with dynamic not static visual acuity scores (r =0.55, p <0.001). Conclusions: These results imply that the gaze instability due to vestibular hypofunction affects reading ability in young children. [Copyright &y& Elsevier]

Summary: Despite impaired gaze stability and reading in children with sensorineural hearing loss (SNHL) and vestibular hypofunction (VH), there are no reports of intervention. We examined the effect of visual-vestibular exercises in two children on dynamic visual acuity (DVA), critical print size (CPS) and reading acuity (RA) using an ABA design. Improvement in CPS and RA was seen in both subjects. DVA improved only in the subject with acquired versus congenital VH. These results suggest that although exercise improves reading acuity, age at the time of lesion affects the improvement of DVA in children with SNHL and BVH. [Copyright &y& Elsevier]