Visual function and subjective quality of life compared in subjects with acquired macular disease

PURPOSE: To determine the objective measures of visual function that are most relevant to subjective quality of vision and perceived reading ability in patients with acquired macular disease. METHODS: Twenty-eight patients with macular disease underwent a comprehensive assessment of visual function. The patients also completed a vision-related quality-of-life questionnaire that included a section of general questions about perceived visual performance and a section with specific questions on reading. RESULTS: Results of all tests of vision correlated highly with reported vision-related quality-of-life impairment. Low-contrast tests explained most of the variance in self-reported problems with reading. Text-reading speed correlated highly with overall concern about vision. CONCLUSIONS: Reading performance is strongly associated with vision-related quality of life. High-contrast distance acuity is not the only relevant measure of visual function in relation to the perceived visual performance of a patient with macular disease. The results suggest the importance of print contrast, even over print size, in reading performance in patients with acquired macular disease.

Varieties of acquired phonological dyslexia

The existence of different varieties of the acquired reading disorder termed "phonological dyslexia" is demonstrated in this thesis. The data are interpreted in terms of an information-processing model of normal reading which postulates autonomous routes for pronouncing lexical and non-lexical items and identifies a number of separable sub-processes within both lexical and non-lexical routes. A case study approach is used and case reports on ten patients who have particular difficulty in processing non-lexical stimuli following cerebral insult are presented, Chapters 1 and 2 describe the theoretical background to the investigation. Cognitive models of reading are examined in Chapter 1 and the theoretical status of the current taxonomy of the acquired dyslexias discussed in relation to the models. In Chapter 2 the symptoms associated with phonological dyslexia are discussed both in terms of the theoretical models and in terms of the cosistency with which they are reported to occur in clinical studies. Published cases of phonological dyslexia are reviewed. Chapter 3 describes the tests administered and the analysis of error responses. The majority of tests require reading aloud of single lexical or non-lexical items and investigate the effect of different variables on reading performance. Chapter 4 contains the case reports. The final chapter summarises the different patterns of reading behaviour observed. The theoretical model predicts the selective impairment of subsystems within the phonological route. The data provide evidence of such selective impairment. It is concluded that there are different varieties of phonological dyslexia corresponding to the different loci of impairment within the phonological route. It is also concluded that the data support the hypothesis that there are two lexical routes. A further subdivision of phonological dyslexia is made on the basis of selective impairment of the direct or lexical-semantic routes.