Word reading

What it measures

Word reading looks at functional near vision with whole words rather than single optotypes. A word appears, stays for a set time, and the patient types it back before it changes. What the clinician watches is whether the word is recognised in the time available, at which word length recognition breaks down, and what the patient does while reading.

Distance acuity says what a patient resolves on a single line of optotypes. A patient with good distance acuity can still struggle with text, because of a central scotoma, reduced contrast sensitivity, an accommodative problem, or an oculomotor problem. A word task shows that difficulty where a line of letters does not.

The word list is localised: 140 English words and a separate 140 French words. Word length is selectable, so the demand runs from short words to long ones.

How it is administered

The patient wears near correction suited to the screen distance. If they read with a magnifier, test with it and record that.

Set the reading distance and keep it, because the angular size of the words depends on it.

Illumination stays even, with no glare. A dim room slows most patients, and low vision patients severely.

Word length and display time are set before starting: begin with a comfortable speed, then shorten the display time or lengthen the words while the patient keeps up. Keep the same settings between sessions, because a shorter display time makes the task harder.

The patient reads each word and types it. It advances as soon as the typed word matches, otherwise when the display time runs out. Test binocularly first, then monocularly where a difference is suspected.

The clinician watches behaviour as much as the screen: losing place, hesitating on longer words, moving closer, turning the head, or tracking with a finger.

Reading the result

VisReed marks each word right or wrong as it is typed and then moves on. It counts nothing, times nothing and keeps no total, so the result is the clinician's own record: the shortest display time and the longest words the patient handled reliably, with the errors that occurred.

Record the settings with the result. Performance at two seconds per word with five-letter words is not comparable with performance at one second with nine-letter words.

Note what the errors look like. Letters transposed, or the end of a word missed, fit an oculomotor or field problem more than an acuity problem. A word missed at a speed the patient handled a moment earlier fits fatigue.

Performance falls with age, with fatigue, and in a language the patient reads less often, so record the reading language.

When it is used

The test is used in low vision assessment, to set magnification and check what a device achieves, and in the follow-up of macular disease. It is used before and after prescribing a near add or a magnifier.

It suits children with reading difficulty, alongside oculomotor testing, and reports functional vision for school, work or a certificate, where how a patient handles words describes the difficulty better than an acuity value.

Limitations

Performance depends on language, education, familiarity with the words and typing ability as much as on the eyes. A slow or inaccurate typist reads here like a patient with an eye problem.

There is no clock and no word counter. The test produces no reading speed in words per minute and no reading acuity. The display time is a setting, not a measure of how long the patient needed.

Word size on a screen is correct only at the distance assumed when it was set. Screen resolution, system scaling and browser zoom all change the rendered size.

Screen contrast and typeface differ from a printed chart, so the two are not interchangeable. Ambient light is not controlled.

A word list is not a standardised reading chart. The words are not matched for frequency or difficulty, so compare within this test rather than against values from a validated chart.

Validated status means this implementation is considered ready for clinical use on this platform. It does not mean a published study has shown equivalence to a printed reading chart.