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Crowded task performance in visually impaired children: magnifier versus large print

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Abstract

Background

This study compares the influence of two different types of magnification (magnifier versus large print) on crowded near vision task performance.

Methods

Fifty-eight visually impaired children aged 4–8 years participated. Participants were divided in two groups, matched on age and near visual acuity (NVA): [1] the magnifier group (4–6 year olds [n = 13] and 7–8 year olds [n = 19]), and [2] the large print group (4–6 year olds [n = 12] and 7–8 year olds [n = 14]). At baseline, single and crowded Landolt C acuity were measured at 40 cm without magnification. Crowded near vision was measured again with magnification. A 90 mm diameter dome magnifier was chosen to avoid measuring the confounding effect of navigational skills. The magnifier provided 1.7× magnification and the large print provided 1.8× magnification. Performance measures: [1] NVA without magnification at 40 cm, [2] near vision with magnification, and [3] response time. Working distance was monitored.

Results

There was no difference in performance between the two types of magnification for the 4–6 year olds and the 7–8 year olds (p’s = .291 and .246, respectively). Average NVA in the 4–6 year old group was 0.95 logMAR without and 0.42 logMAR with magnification (p < .001). Average NVA in the 7–8 year was 0.71 logMAR without and 0.01 logMAR with magnification (p < .001). Stronger crowding effects predicted larger improvements of near vision with magnification (p = .021).

Conclusions

A magnifier is equally effective as large print in improving the performance of young children with a range of visual acuities on a crowded near vision task. Visually impaired children with stronger crowding effects showed larger improvements when working with magnification.

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References

  1. Cox RF, Reimer AM, Verezen CA, Smitsman AW, Vervloed MP, Boonstra FN (2009) Young children’s use of a visual aid: an experimental study of the effectiveness of training. Dev Med Child Neurol 51:460–467

    Article  PubMed  Google Scholar 

  2. Schurink J, Cox RF, Cillessen AH, van Rens GH, Boonstra FN (2011) Low vision aids for visually impaired children: a perception-action perspective. Res Dev Disabil 32:871–882

    Article  PubMed  CAS  Google Scholar 

  3. Cox RFA, Reimer AM, Smitsman AW, Verezen CA, Vervloed MPJ, Boonstra FN (2007) Low-vision aids for young visually impaired children: learning to use a magnifier. In: Cummins-Sebree S, Riley M, Shockley K (eds) Studies in action and perception IX. Erlbaum, Hillsdale, pp 143–146

    Google Scholar 

  4. Reimer AM, Cox RF, Nijhuis-Van der Sanden MW, Boonstra NF (2011) Improvement of fine motor skills in children with a visual impairment: an explorative study. Res Dev Disabil 32:1924–1933

    Article  PubMed  CAS  Google Scholar 

  5. Alabdulkader B, Leat SJ (2010) Reading in children with low vision. J Optom 3:68–73

    Article  Google Scholar 

  6. Farmer J, Morse SE (2007) Project magnify: increasing reading skills in students with low vision. J Visual Impair Blin 101:763–768

    Google Scholar 

  7. Katz M, Zikos G (1994) Apparent image quality of magnifiers depends on amplitude of accommodation. Optom Vis Sci 7:226–234

    Article  Google Scholar 

  8. Cakmakci O, Rolland J (2007) Comparative analysis of doublets versus single-layer diffractive optical elements in eyepiece or magnifier design. Appl Opt 46:8140–8148

    Article  PubMed  Google Scholar 

  9. Rydberg A, Ericson B, Lennerstand G, Jacobson L, Lindstedt E (1999) Assessment of VA in children aged 1 ½ -6 years, with normal and subnormal vision. Strabismus 7:1–24

    Article  PubMed  CAS  Google Scholar 

  10. Huurneman B, Boonstra FN, Cillessen AHN, van Rens G, Cox RFA (2012) Crowding in central vision in normally sighted and visually impaired 4–8 year old children: the influence of age and test design. Strabismus 20:55–62

    Article  PubMed  Google Scholar 

  11. Huurneman B, Boonstra NF, Cox RFA, Cillessen AHN, van Rens G (2012) A systematic review on ‘foveal Crowding’ in visually impaired children and perceptual learning as a method to reduce crowding. BMC Ophthalmol 12:1–14

    Article  Google Scholar 

  12. Jeon ST, Hamid J, Maurer D, Lewis TL (2010) Developmental changes during childhood in single-letter acuity and its crowding by surrounding contours. J Exp Child Psychol 107:423–437

    Article  PubMed  Google Scholar 

  13. Jacobson L, Ek E, Fernell E, Flodmark O, Broberger U (1996) Visual impairment in preterm children with periventricular leukomalacia-visual, cognitive and neuropaediatric characteristics related to cerebral imaging. Dev Med Child Neurol 38:724–735

    Article  PubMed  CAS  Google Scholar 

  14. Tinker MA (1963) Legibility of print. Iowa State University Press, Ames

    Google Scholar 

  15. Legge GE, Mansfield JS, Chung STL (2001) Psychophysics of reading. XX: linking letter recognition to response time in central and peripheral vision. Vis Res 41:725–743

    Article  PubMed  CAS  Google Scholar 

  16. Hohmann A, Haase W (1982) Development of visual line acuity in humans. Ophthal Res 14:107–112

    Article  CAS  Google Scholar 

  17. Haase W (1993) Quantitative measurement of crowding. Arch Chil Oftal 1:127–129

    Google Scholar 

  18. Douglas G, Grimley M, Hill E, Long R, Tobin MJ (2002) The use of the NARA for assessing the reading ability of children with low vision. Br J Vis Impair 20:68–75

    Article  Google Scholar 

  19. Douglas G, Grimley M, McLinden M, Watson L (2004) Reading errors made by children with low vision. Ophthalmic Physiol Opt 24:319–322

    Article  PubMed  Google Scholar 

  20. Bevan JD, Lovie-Kitchin JE, Hein B, Ting E, Brand P, Scott M, Fotkou P (2000) The effect of relative size magnification versus relative distance magnification on the reading performance for children with low vision. In: Vision Rehabilitation: Assessment, Intervention and Outcomes. Lisse, The Netherlands: Swets & Zeitlinger, 428–432

  21. Kooijman AC, Stellingwerf N, van Schoot EAJ, Cornelissen FW, van der Wildt GJ (1994) Groningen Edge Contrast Chart (GECKO) and glare measurements. In: Kooijman AC, Looijestijn PL, Welling JA, van der Wildt GJ (Eds.). Low vision. IOS Press:101–110

  22. Taylor HR (1978) Applying new design principles to the construction of an illiterate E chart. Am J Optom Physiol Opt 55:348–351

    Article  PubMed  CAS  Google Scholar 

  23. Bailey IL, Bullimore MA, Greer RB, Mattingly WB (1994) Low vision magnifiers-their optical parameters and methods for prescribing. Optom Vis Sci 71:689–698

    Article  PubMed  CAS  Google Scholar 

  24. Lovie-Kitchin JE, Bevan JD, Hein B (2001) Reading performance in children with low vision. Clin Exp Optom 84:148–154

    Article  PubMed  Google Scholar 

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Acknowledgments

No conflicting relationship exists for any author. This research was funded by the Dutch Organization for Health and Research Development (grant number 60-00635-98-066, ZonMW, program Insight). The authors want to thank the parents and children for their participation.

Author information

Authors and Affiliations

  1. Bartiméus, Institute for the Visually Impaired, Zeist, The Netherlands

    Bianca Huurneman, F. Nienke Boonstra & Ralf F. A. Cox

  2. Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands

    Bianca Huurneman, F. Nienke Boonstra & Antonius H. N. Cillessen

  3. Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands

    F. Nienke Boonstra

  4. Department of Ophthalmology, UMCN St Radboud, Nijmegen, The Netherlands

    Cornelis A. Verezen

  5. Free University Medical Centre, Amsterdam, The Netherlands

    Ger van Rens

  6. Department of Developmental Psychology, University of Groningen, Groningen, The Netherlands

    Ralf F. A. Cox

Authors
  1. Bianca Huurneman
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  2. F. Nienke Boonstra
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  3. Cornelis A. Verezen
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  4. Antonius H. N. Cillessen
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  5. Ger van Rens
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  6. Ralf F. A. Cox
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Corresponding author

Correspondence to Bianca Huurneman.

Additional information

Trial registration number: NTR2537 (http://www.trialregister.nl)

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Huurneman, B., Boonstra, F.N., Verezen, C.A. et al. Crowded task performance in visually impaired children: magnifier versus large print. Graefes Arch Clin Exp Ophthalmol 251, 1813–1819 (2013). https://doi.org/10.1007/s00417-013-2291-x

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  • DOI: https://doi.org/10.1007/s00417-013-2291-x

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