title: Reading ability and reading engagement in older adults with glaucoma.
abstract: OBJECTIVE
  We evaluated the impact of glaucoma-related vision loss on reading ability and reading engagement in 10 reading activities.
  
  
  METHODS
  A total of 63 glaucoma patients and 59 glaucoma suspect controls self-rated their level of reading difficulty for 10 reading items, and responses were analyzed using Rasch analysis to determine reading ability. Reading engagement was assessed by asking subjects to report the number of days per week they engaged in each reading activity. Reading restriction was determined as a decrement in engagement.
  
  
  RESULTS
  Glaucoma subjects more often described greater reading difficulty than controls for all tasks except puzzles (P < 0.05). The most difficult reading tasks involved puzzles, books, and finances, while the least difficult reading tasks involved notes, bills, and mail. In multivariable weighted least squares regression models of Rasch-estimated person measures of reading ability, less reading ability was found for glaucoma patients compared to controls (β = -1.60 logits, P < 0.001). Among glaucoma patients, less reading ability was associated with more severe visual field (VF) loss (β = -0.68 logits per 5-dB decrement in better-eye VF mean deviation [MD], P < 0.001) and contrast sensitivity (β = -0.76 logits per 0.1-unit lower log CS, P < 0.001). Each 5-dB decrement in the better-eye VF MD was associated with book reading on 18% fewer days (P = 0.003) and newspaper reading on 10% fewer days (P = 0.008). No statistically significant reading restriction was observed for other reading activities (P > 0.05).
  
  
  CONCLUSIONS
  Glaucoma patients have less reading ability and engage less in a variety of different reading activities, particularly those requiring sustained reading. Future work should evaluate the mechanisms underlying reading disability in glaucoma to determine how patients can maintain reading ability and engagement.
authors: Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States.
authors: Angeline M
authors: AM
authors: Nguyen
authors: Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States.
authors: Suzanne W
authors: SW
authors: van Landingham
authors: Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States.
authors: Robert W
authors: RW
authors: Massof
authors: National Institute for Health Research Biomedical Research Centre (NIHR BRC) for Ophthalmology, University College London (UCL) Institute of Ophthalmology and Moorfields Eye Hospital, London, United Kingdom Visual Neuroscience, UCL Institute of Ophthalmology, London, United Kingdom.
authors: Gary S
authors: GS
authors: Rubin
authors: Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, United States.
authors: Pradeep Y
authors: PY
authors: Ramulu
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015350:Contrast Sensitivity / Q000502:physiology; D005260:Female; D005901:Glaucoma / Q000150:complications / Q000503:physiopathology*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011932:Reading; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000209:etiology / Q000503:physiopathology*; D014794:Visual Fields / Q000502:physiology
keywords: glaucoma; low vision; quality of life; reading