Psychophysics Of Reading
Psychophysics of ReadingXV: Font Effects in Normal and Low Vision/ . Stephen Mansfield,* Gordon E. Legge* and Mark C. Bane\Purpose. Little is known about the effect of font on low-vision reading. In this study, theauthors measured the influence of font in reading with normal and low vision.Methods. Reading acuity, maximum reading speed, and critical print size (the smallest printthat can be read with maximum speed) were measured in 50 normal subjects and 42 subjectswith low vision. Data were collected using versions of the MNREAD Acuity Chart printed withthe Times (proportionally spaced) and Courier (fixed-width) fonts.Results. Reading acuity scores obtained with Courier were better than those obtained withTimes for both normal (mean difference, 0.05 logMAR, P 0.001) and subjects with lowvision (0.09 logMAR, P 0.001). Similarly, critical print sizes measured with Courier weresmaller than those measured with Times (mean difference, 0.06 logMAR for normal subjectsand subjects with low vision, P 0.002). Maximum reading speeds for normal subjects were5% faster with Times than with Courier (P 0.001), but for subjects with low vision, maximumreading speeds were 10% slower with Times than with Courier (P 0.05). For print smallerthan the critical print size, the reading speeds of normal subjects and subjects with low visionwere substantially slower (by as much as 50%) for Times than for Courier.Conclusions. There are small, but significant, advantages of Courier over Times in readingacuity, critical print size, and reading speed for subjects with low vision. For normal subjects,the differences are slighter, with an advantage in reading speed for Times. However, for printsizes close to the acuity limit, choice of font could make a significant difference in bothnormal and low-vision reading performance. Invest Ophthalmol Vis Sci. 1996;37:1492-1501.Jtlow is reading performance influenced by font? This question has particular importance, not only forthe improved design of everyday reading material(e.g., road signs, medicine labels, news print, andbooks) but also for the design of clinical reading acuitytests.Tinker' performed a systematic analysis of the influence of font on print legibility and found only smallFrom the * Minnesota Laboratory for Lou -Vision Research, Department ofPsychology, University of Minnesota; and the f Retina Foundation of the Southwest,DalUis, Texas.Suf ported by National Institutes of Health grant EY02934 (GEL).Submitted for publication August 30, 1995; revised January 16, 1996; acceptedMarch II, 1996.Proprietary interest category: P.Rejmnt requests: J. Stej hen Mansfield, Department of Psychology, University ofMinnesota, 75 East River Road, Minneapolis, MN 55455.X We use the term font to refer to a particular design of printedtype, such as Helvetica, Times, or Courier. Our use differs fromthe precise typographical definition of font but is consistent withcommon usage.1492effects on reading performance. Recently, however,studies have investigated specific differences in reading performance found with fixed-width and proportionally spaced fonts.2"5 In a fixed-width font, eachcharacter takes up the same amount of horizontalspace, whereas in a proportionally spaced font, different letters take up different amounts of horizontalspace. Arditi et al4 measured reading speeds with proportionally spaced and fixed-width versions of thesame font. For large print sizes, proportionally spacedtext was read slightly faster than fixed-width text,whereas with small print, proportionally spaced textwas read considerably slower than fixed-width text.Morris et al5 attempted to replicate this finding but,over a wide range of angular print sizes, found nodifference in reading speed between fixed- and proportionally spaced fonts. They noted that Arditi etal4 had manipulated print size in two ways: either bychanging the viewing distance to the screen, or byusing physically smaller, lower-resolution renderingsInvestigative Ophthalmology & Visual Science, July 1996, Vol. 37, No. 8Copyright Association for Research in Vision and OphthalmologyDownloaded From: https://iovs.arvojournals.org/pdfaccess.ashx?url /data/journals/iovs/933193/ on 01/07/2019
The Effect of Font on Readingof the font. For the smallest print sizes used by Arditiet al,4 the print resolution was 9 pixels per letterheight. Only by using a similarly low print resolutionwere Morris et al5 able to find a reading speed advantage for the fixed-width font at small sizes.Thus, it is uncertain whether the differences between fixed- and proportional-spacing found by Arditiet al4 reflect reading performance with normal printor whether they are limited to print rendered at lowresolutions. One purpose of our study was to reexamine the effect of proportional versusfixed-widthspacing on reading.Recent estimates6'7 suggest that more than 3 million people in the United States are visually impaired.Of these, approximately 120,000 are classified as blind(no useful pattern vision) and the remainder are classified with low vision (corrected visual acuity less than20/60 or a visual field less than 30 ). A more functional definition of low vision is the inability to readnewsprint at a normal reading distance (40 cm) withstandard refractive correction. Indeed, most peoplewith low vision have difficulty reading.7 Earlier articlesin this series have shown how reading speed with lowvision depends on character and field size,8 text contrast,9 and color.10 Little is known, however, about theimpact of font on reading for patients with low vision.Few studies have addressed directly how font affects low-vision reading. Prince""13 measured readingspeed in subjects with low vision and in normal subjects with pseudomyopia (myopia simulated using dioptric blur). He found that, for a given print size,faster reading speeds were obtained by increasing thewidth of the space between letters (from 0.2 to 0.4letter widths). Arditi et al4 noted that patients withlow vision with macular disease found fixed-width textto be easier to read than proportionally spaced text.There is reason to suspect that low-vision readingmay be particularly sensitive to font. For example,crowding effects purportedly are stronger in peripheral vision,1415 raising the possibility that people withcentral field loss, who use peripheral vision to read,would be at a special disadvantage reading a font withtight letter-to-letter spacing. Furthermore, many persons with low vision read text at print sizes near theiracuity limit. In such circumstances, even a small difference in the legibility between fonts could make thedifference between ability and inability to read. Indeed, some subjects in Prince's study12 were unable toread text with normal letter spacing but were able toread text with broader letter spacing.In this study, we addressed the following questions: What is the effect of font on normal readingperformance? Are these effects the same with lowvision? How might the choice of font influence theclinical assessment of low-vision reading performance?1493Everyone wanted togo outside when therain finally stoppedBWe both racedinto the yardwhen we heardthe fire belli. (A) Times-Roman, and (B) Courier-Bold sentences from the MNREAD Acuity Charts.FIGUREMETHODSStimuliWe used two versions of the MNREAD Acuity Chart16to compare reading performance with two fonts. TheMNREAD Acuity charts are continuous-text readingacuity charts, consisting of a series of 19 sentencesprinted at progressively smaller sizes. Within eachchart, the sentences have the same number of characters and geometrical layout. The vocabulary was chosen from the most common words in printed English,17 and the charts were matched for reading difficulty.We compared reading performance with twofonts: Adobe's Times-Roman (version 001.007) andCourier-Bold (version 002.004). These fonts resemblethose found in everyday reading material: Times is aproportionally spaced font similar to that used inmany books, magazines, and newspapers, whereasCourier has fixed width and is like that produced bytypewriters or some computer displays. Our font selection differs from that of Arditi et al,4 who constructedtheir fixed-width font by adding extra white space toeither side of the letterforms in their proportionallyspaced font so that they all had the same width. Theirmethod produced fonts that were identical in all aspects other than in their character spacing, but theresultant fixed-width type was unlike any font foundin normal typography. In our study, the two fontscome from different type families, and, accordingly,they differed in numerous aspects besides either fixedor proportional spacing (see Fig. 1). Any of the differences between the fonts might be expected to influence reading performance.Sample sentences for both fonts, formatted as theyDownloaded From: https://iovs.arvojournals.org/pdfaccess.ashx?url /data/journals/iovs/933193/ on 01/07/2019
1494Investigative Ophthalmology & Visual Science, July 1996, Vol. 37, No. 8are on the MNREAD charts, are shown in Figure 1.Each Times sentence had 60 characters (includingspaces between words and an implied period at theend) and was printed onto three lines of left-rightjustified text. Each Courier-Bold sentence had 56 characters and was printed onto four lines of text.For both fonts, print size was defined as the heightof a lower case x (x-height), in accord with the recommended procedure for the specification of visual acuity.18 LogMAR print size is given by: Iogi0[ (angle subtended by x-height)/5 arc min]. At a viewing distanceof 40 cm, the print sizes ranged from 1.3 to —0.5logMAR (Snellen, 20/400 to 20/6.3; visual angles,1.66 to 0.026 ) with a step size of 0.1 logMAR (i.e.,the print on each successive sentence is 80% the sizeof the previous sentence). When necessary, a largerangular print size could be obtained by using a shorterviewing distance.The charts were viewed in a well-lit room so thatlight reflected from the chart surface was at least 80cd/m 2 . The charts were printed with high-contrast(Michelson contrast, 90%) black text on a white background at a resolution of 3000 dots per inch. Withthis high resolution, the x-height of the smallest print(—0.5 logMAR) corresponded to 22 pixels. For comparison, 12 point Times-Roman type rendered with300 dots per inch also corresponds to 22 pixels per xheight. This print resolution avoids the low-resolutionproblems noted by Morris et al.5SubjectsData were collected from 50 undergraduate psychology students with normal or corrected-to-normal vision and from 42 subjects with low vision. All subjectsspoke English as their native language and gave theirinformed and written consent to participate in thestudy (in accordance with the Declaration of Helsinki) . Low-vision data were collected at two sites: 22subjects were tested at the Minnesota Laboratory forLow-Vision Research (Minneapolis), and 20 weretested at the Retina Foundation of the Southwest (Dallas, TX). Age, distance acuity, and diagnoses of bothsubject pools are shown in Table 1. We subdivided thesubjects with low vision into two groups based on thestatus of their central visual field: either intact or loss(scotomas covering all or part of the central 5 ofvisual field).8 Mean age and distance acuities ( SD)for these groups were as follows: intact central vision,41 11.2 years, 0.87 0.52 logMAR (20/148); centralvision loss, 68 15.4 years, 0.85 0.35 logMAR (20/148).ProcedureFor subjects with normal vision, the viewing distancewas 40 cm. For subjects with low vision, viewing distance was chosen so that, using their usual opticalcorrection for reading, they would be able to readsix or more sentences. Viewing distance was maintained either by resting the subject's head against aforehead rest or by verifying the viewing distancethroughout the reading trials. The charts wereplaced on a reading stand in front of the subject.Subjects with low vision who preferred to read usinga specific retinal location were allowed to positionthe chart so that the text would fall into their preferred region of vision.Starting with the largest print size, subjects wereinstructed to read each sentence, one at a time, asquickly and as accurately as possible. Subjects continued reading the smaller sizes until they could not readany words in a sentence. The subjects were informedthat reading speed was being measured and wereasked to continue reading to the end of the sentencebefore correcting any reading errors they might havemade. To prevent subjects from reading ahead, theunread sentences were covered with a piece of cardheld by the experimenter. For data collected at theMinnesota laboratory, a stopwatch was used to recordthe time taken to read each sentence, and any readingerrors were noted during the test session. For datacollected at the Texas laboratory, the test session wasrecorded on audiotape, and reading time and readingerrors were scored after the test session.Data AnalysisWe measured three parameters of reading performance: reading acuity, the smallest print size that canjust be read; maximum reading speed, the readingspeed at which print size is not a limiting factor; critical print size, the smallest print that can be read atthe maximum reading speed.Reading acuity was calculated in a similar mannerto the "letter-by-letter" method described by Ferris etal19 for scoring visual acuity with letter charts. On eachchart, the sentences were subdivided into "standardlength" words of six characters each. 20 Each sentencehad 10 standard-length words on the Times charts and9.33 standard-length words on the Courier charts. Thesentence-to-sentence size increment was 0.1 logMAR,so that, following the principle of Ferris et al,10 eachword was "worth" either 0.01 or 0.0108 (i.e., 0 . 1 /9.33) logMAR for the Times and Courier charts, respectively. (Our use of standard-length words was intended to minimize the differences in scoring thatwould occur because of the different word lengthsfound in different sentences. For example, some ofthe test sentences have 13 relatively short words,whereas others have just 10 words of a longer length.)Reading acuity was determined as follows: Startingwith an acuity score of 1.4 (i.e., one 0.1 logMAR steplarger than the largest print on the chart) the subject'slogMAR score was decremented by 0.1 logMAR forDownloaded From: https://iovs.arvojournals.org/pdfaccess.ashx?url /data/journals/iovs/933193/ on 01/07/2019
The Effect of Font on ReadingTABLE1495l. Subjects With Low VisionSubjectAge (years)Distance Acuity 17274757676777881818182828383every sentence that was read with less than 10 readingerrors. Then, for each word that was missed or readincorrectly, the subject's score was increased by 0.01logMAR on the Times charts or 0.0108 logMAR onthe Courier chart. Finally, the reading acuity score wasmodified to take into account the viewing distanceused (if it was other than 40 cm).Reading speed in words per minute (wpm) wasdetermined for each sentence as the number of standard length words read correctly, divided by the timetaken to read the sentence (measured to the nearest0.1 seconds). For data collected in the Minnesota laboratory, the reading time was measured from the moment the sentence was revealed to the subject untilCentral Field sLossLossCataract, nystagmusCataractsCataractsCorneal opacificationDiabetic retinopathyGlaucomaGlaucomaOptic neuritisOptic neuritis, ischemicProgressive myopiaRetinitis pigmentosaRetinopathy of prematurityRetinopathy of prematurityAge-related macular degenerationAge-related macular degenerationDetached retinaDiabetic retinopathyJuvenile macular degenerationLeber's diseaseLeber's diseaseOptic nerve deteriorationOptic neuritis, atrophyAge-related macular degenerationAge-related macular degenerationAge-related macular degenerationAge-related macular degenerationAge-related macular degenerationAge-related macular degenerationAge-related macular degenerationAge-related macular degenerationAge-related macular degenerationAge-related macular degenerationAge-related macular degenerationAge-related macular degenerationAge-related macular degenerationAge-related macular degenerationAge-related macular degenerationAge-related macular degenerationAge-related macular degenerationAge-related macular degenerationAge-related macular degenerationAge-related macular degenerationthe subject finished uttering the last word of the sentence. For data collected in the Texas laboratory, reading time was recorded from when the subject startedto utter the first word until the last word was finished.Patients with central vision loss may experience difficulties in finding the sentence on the page. The lattermethod for calculating reading speed excludes thetime taken to localize the sentence and may give abetter representation of reading time for subjects withcentral field loss.Typically, reading speed remains constant over awide range of print sizes, but, as print size is reduced,reading speed deteriorates before die acuity limit isreached (see Fig. 2). We defined the maximum read-Downloaded From: https://iovs.arvojournals.org/pdfaccess.ashx?url /data/journals/iovs/933193/ on 01/07/2019
Investigative Ophthalmology & Visual Science, July 1996, Vol. 37, No. 814961000Q.QLULLJQC/D100 rCD LU-0.30.00.30.60.91.21.5PRINT SIZE (logMAR)FIGURE 2. Reading speed as a function of print size is shownfor a subject with normal vision. Solid lines indicate the bestfitting two-limbed fit for the data. The dashed line indicatesthe two-limbed fit when the data point for the —0.3 logMARsize is excluded from the two-limbed-fit analysis. Filled symbols indicate data points considered to lie on the plateauregion of the reading speed curve (see Data Analysis andappendix for details). Hollow symbols represent speeds thatare significandy slower than the mean reading speed acrossthe plateau.ing speed as the reading speed across the plateau region and the critical print size as the print size atwhich reading speed starts to deteriorate. Both theseparameters are important functional measures ofreading performance. The maximum reading speed isan objective measure of the best reading performanceattainable by the subject. The critical print size is theoptimal print size for reading because it is the smallest0.1print size at which subjects read with their maximumrate. When prescribing a magnifier or reading aid, thecritical print size indicates the optimum magnificationthat would suit the patient.Previously21'22 we obtained estimates of the criticalprint size using a two-limbed straight-line fit to thereading speed data: a sloped line for small print sizesand a horizontal line for larger sizes (shown by thesolid lines in Fig. 2). Using this method, the criticalprint size is at the elbow (the intersection) of the twolines. We have not used this method in the currentstudy, however, because the precise location of theelbow in the two-limbed fit is acutely dependent onthe reading speed measurements that define thesloped line. Typically, these data points are collectedat print sizes close to the observer's acuity limit, wherethe reading speed measurements can be noisy. Forexample, in Figure 2, the intersection of the twolimbed fit corresponds to a print size of —0.14logMAR. In this example, the subject read only twowords correcdy in the
The Effect of Font on Reading 1493 of the font. For the smallest print sizes used by Arditi et al,4 the print resolution was 9 pixels per letter height. Only by using a similarly low print resolution were Morris et al5 able to find a reading speed advan-tage for the fixed-width font at small sizes. Thus, it is uncertain whether the differences be-
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