ArticleBMC ophthalmology2026
Evaluation of reading performance in eyes simulated with different visual acuity and visual field impairment.
Article in BMC ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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3 authors.
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Abstract
backgroundFixed time extensions for visually impaired examinees ignore the wide variability in visual-acuity (VA) and visual-field (VF) deficits. Such one-size-fits-all policies may compromise fairness in high-stakes testing.
methodsThirty healthy adults (20–40 y) completed two exam-like tasks—oral reading and word search—under ten simulated visual conditions. VA was degraded to decimal 0.4 (logMAR 0.40; ≈20/50) or decimal 0.1 (logMAR 1.00; ≈20/200) using plus-lens fogging at 40 cm; a 0.9-mm pinhole (PH) imposed an approximately 10–15° concentric VF restriction. Font size were normal or enlarged. Each participant served as their own control; the baseline testing condition was decimal VA 1.0, no pinhole, normal font size. Task completion time was recorded; paired t-tests with Bonferroni correction assessed differences.
resultsCompared with baseline, moderate blur alone (VA 0.4/–PH) lengthened reading by 15–20% and search by ~ 17%. Adding a PH doubled search time at normal VA (97.7 s to 162.7 s, p < 0.001) and nearly doubled it at VA 0.4 (114s to 189 s, p < 0.001). The most severe condition (VA 0.1/+PH, enlarged font) required 1.42 × baseline time for reading and 3.12 × for search. Enlarging print reduced acuity-related reading delays but paradoxically increased search times because the scan area expanded.
conclusionsReading speed is significantly limited by VA, whereas visual search is dominated by VF integrity. A single fixed time allowance (e.g., + 20–40 min) cannot accommodate all impairment profiles. Our findings suggest that test-time accommodations should be scaled separately—approximately 1.4 × the baseline for severe blur and 3.1 × for combined blur with field loss—rather than applying a single fixed extension. Such task-specific adjustments offer a principled path toward equitable testing for candidates with diverse visual limitations.
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