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Clinical Relevance: The support of students with a vision impairment throughout education could be enhanced by assessing the functional reading ability of the individual. This visual assessment could inform educators of individualised student needs and potentially improve the academic achievement for these students. Background: Support for children with a vision impairment within a classroom is typically based on clinical findings of distance visual acuity and visual fields. Therefore, determining optimal print size for reading is essential to ensure best academic outcomes. Secondary aims were to investigate the possible impact of underlying pathology on reading ability. Methods: Forty-seven participants were recruited from a state-wide support service for children with a vision impairment in South Australia. Three visual acuity groups were formed based on World Health Organisation definitions of mild, moderate, and severe vision impairment. Correlation between clinical measures of distance visual acuity using the Freiburg Visual Acuity Test, were compared with reading acuity and critical print size (smallest font before reading speed reduced) using Minnesota low vision reading chart (MNREAD). Results: No significant correlations were found for mild (0.20–0.49 logMAR) and severe (1.00–1.52 logMAR) vision impairment groups between distance visual acuity and reading acuity read (p =.64, CI [−.585,.395]/p =.82, CI [−.48,.58]) or critical print size (p =.78, CI [−.57,.45]/p =.43, CI [−.34,.68]. A significant correlation was found for the moderate vision impairment group: 0.50–0.99 logMAR for minimum reading acuity (p <.001, CI [.44,.91]) and critical print size (p =.03, CI [.05,.80]). Conclusions: Standard clinical measures of distance visual acuity are an unpredictable estimate of reading ability in children with mild and severe vision impairment. Additional measures of functional near reading ability could provide a more meaningful indicator of reading ability and help provide optimum support to students through education. [ABSTRACT FROM AUTHOR]

Keywords: Cone dystrophy; education; reading; quality of life; visual acuity; visual function EN Cone dystrophy education reading quality of life visual acuity visual function 774 777 4 09/05/22 20220901 NES 220901 Introduction This case report highlights the need to evaluate the adequacy of standard measures alone to assess the impact of vision impairment on learning within the classroom environment. This case report describes a 13-year-old girl (AR) with a cone dystrophy who has just transitioned from a specialist vision impairment school into a large mainstream high school in South Australia. It investigates differences in the standard visual function tests and compares these metrics to AR's visual performance, including self-reported impact of the vision impairment within the school environment for AR. [Extracted from the article]

Clinical Relevance: Children with vision impairment can have difficulty accessing classroom reading material and knowledge of which students are likely to have improved performance reading performance with reverse polarity would be of value to educators., Background: Printed material is typically presented as black text on a white background; however, reversing the polarity to white text on a black background may improve the reading speed for children with vision impairment. This study sought to identify the visual function or pathological features of children with vision impairment where reversing the polarity of text would improve their reading performance., Methods: Forty-eight vision-impaired participants (27 male), aged 5-18 years with binocular visual acuities between 0.18-1.52 logMAR, were included. Reading performance was assessed by changes in Critical Print Size (ΔCPS), Maximum Reading Speed (ΔMRS) in normal and reverse polarity digital print, and numeric reading speed (ΔNRS) with normal and reverse polarity fonts. Correlations were made with 30 Hz flicker electroretinogram amplitude and high/low contrast acuity. Paired nonparametric tests evaluated significance in pathological condition groups., Results: Significant negative correlations were only found between the 30 Hz flicker amplitude and ΔMRS ( r = -.42, p  = .028) and ΔNRS ( r = -.46, p  = .027). Follow-up pairwise comparisons based on pathology group only showed a significant effect of the retinal dystrophy group and CPS ( n  = 12, z = -2.24, p = .025). All other pairwise comparisons based on group were non-significant ( p  > .05)., Conclusions: This study did not identify a specific pathological group or visual functional measure that could be used as a clinical marker to predict the impact of reversing polarity. However, significant improvements could be made in reading performance for some children and so a reading performance assessment is recommended for all children with vision impairment.