Reading acuity in children: evaluation and reliability using MNREAD charts.
OBJECTIVE
To study reading acuity in children and assess the reliability of its measurement using the Italian version of the MNREAD reading chart.


METHODS
One hundred sixteen children from grades 3 to 8 with normal near vision were tested at a pediatric eye care institution in northeastern Italy. Visual acuity was evaluated with Early Treatment Diabetic Retinopathy Study (ETDRS) charts and reading acuity with MNREAD charts. Examination with charts 1 and 2 by the same examiner in the same visit were used as test-retest measurements.


RESULTS
Mean improvement of performance from grades 3 to 8 was approximately 1 line for ETDRS acuity and 1.5 sentences for reading acuity and critical print size. Mean maximum reading speed increased from 96 to 167 words/minute. Regression analysis showed that a stable reading speed was obtained throughout sentences of decreasing size up to the critical print size. Measurement error, expressed as 95% limits of agreement, was +/- 0.136 logarithm of the minimum angle of resolution (logMAR) and +/- 0.142 logMAR for ETDRS acuity and reading acuity, respectively. Critical print size had the lowest reliability (+/- 0.193 logMAR). Maximum reading speed limits of agreement were +/- 0.077 logarithm of words per minute (logWPM), or a 19% change in words per minute. There were no detectable effects of grade and refractive error on measurement errors.


CONCLUSIONS
In children, MNREAD charts provide measurements of reading acuity as reliable as ETDRS chart measurements of distance acuity on a logMAR scale. They also provide highly reliable measurements of the maximum reading speed across all grades, independent of its noticeable increase.
Eye Clinic II, Department of Oto-Neuro-Ophthalmological Surgical Sciences, University of Florence, Florence, Italy. gianni.virgili@unifi.it
Gianni
G
Virgili
Claudia
C
Cordaro
Anna
A
Bigoni
Sabrina
S
Crovato
Paolo
P
Cecchini
Ugo
U
Menchini
D000293:Adolescent; D002648:Child; D004522:Educational Status; D006801:Humans; D007558:Italy; D011932:Reading; D012016:Reference Values; D015203:Reproducibility of Results; D013997:Time Factors; D014787:Vision Tests / Q000592:standards*; D014792:Visual Acuity