Higher Contrast, Larger Font Helpful for Those with Glaucoma

Compared with higher contrast, line spacing and font size had a less pronounced effect regarding saccades and fixations in reading patterns. Photo: Austin Peay State University. Click image to enlarge. Reading difficulty is a top complaint for glaucoma patients. Previous studies from a group of Brazilian researchers have revealed that patients with glaucoma show significantly slower reading speed than participants similarly aged and with similar visual acuity. While reading speed improved in both groups by using text with higher contrast, it had a more significant improvement in the glaucoma group. Their recent study used eye tracking to evaluate reading patterns—saccades, fixations and reading speed—under three different interventions, including increasing font size, line spacing and contrast in glaucoma patients, as well as to compare their performance with that of normal participants. The researchers found that higher contrast significantly improved reading performance in these glaucoma patients by enhancing eye-movement efficiency, reducing the number of saccades and fixations and thereby boosting their reading potential.This cross-sectional study, which was published in Scientific Reports, included 111 patients (57 patients with glaucoma and 54 controls), with no ocular diseases other than glaucoma, and collected demographic and ophthalmologic data. Glaucoma was defined as progressive changes on fundus stereophotographs and/or documented compatible visual field defects. All patients had at least a best-corrected visual acuity of 0.5 logMAR in the left eye. Participants performed a reading performance exercise using the MNREAD chart displayed on a computer screen, with five slides of each progressive intervention. Reading speed was calculated in words per minute; the study also measured number and amplitude of saccades, number of fixations and fixation duration. The mean age was 61.8 and 66.5 years in the glaucoma and control groups, respectively. Educational level had no difference between the two groups.Average best-corrected visual acuity in the left eye was 0.18 logMAR and 0.04 logMAR in the glaucoma and control groups, respectively. Increased contrast had the most significant impact regarding reading patterns in the glaucoma group, improving reading speed and reducing both the number of saccades and fixations.Both groups had difficulty reading the lowest contrast slide (0.1 logCS), resulting in no significant difference in reading speed in the univariate analysis and a paradoxically faster reading speed. The researchers proposed that this counterintuitive result may be attributed to a ceiling or floor effect at the contrast threshold, where both groups reached a performance limit. The 0.15 logCS and the 0.6 logCS slides revealed, as they expected, lower reading speed in the glaucoma group compared to controls, along with a higher number of saccades and fixations and reduced saccade amplitude.“These findings suggest that impaired reading performance at lower contrast levels could be explained by abnormal oculomotor behavior in patients with glaucoma,” the study authors wrote in their paper.The research team did note that daily reading is very difficult to replicate in controlled studies. Reading aloud and on shorter sentences, as required by the MNREAD test chart, also differs from silently reading longer texts. In this study, reading aloud was preferred to avoid having misreading, stutter and delay inform the end of each task. Also, the potential influence of glaucoma medications on the ocular surface, and thereby on reading performance, remains a concern.“Our finding is a step forward for optimized clinical and educational materials, ‘glaucoma-friendly’ presets on e-readers and other devices, as well as improving independence, social engagement and quality of life for individuals living with glaucoma,” the study concluded.Click here for the journal source. Ikeda MC, Messias AMV, Teixeira SH, et al. Eye-tracking reading patterns across different interventions in glaucoma patients vs. controls. Sci Rep. April 27, 2026. [Epub ahead of print]. This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.