All eligible patients with complaints of difficulty performing sustained reading tasks, such as reading books or magazines, will be evaluated for their preference for filter color and lighting using the LuxIQ/2.
Baseline distance visual acuity, contrast sensitivity, and near visual acuity, will be evaluated during initial presentation to the clinic as part of usual care using validated tests that are routinely performed during a low vision examination. Best-corrected distance visual acuity will be determined using the ETDRS (Early Treatment for Diabetic Retinopathy Study) chart. Contrast sensitivity will be evaluated using the MARS contrast sensitivity chart. Best-corrected near visual acuity will be evaluated using the Lighthouse Continuous Text Card. The LuxIQ/2 will be administered 3 times at 15-minute intervals. Lighting preferences will be evaluated 3 times using the Ott Lite Cobra. Each subject will be asked to choose between their preferred lighting conditions as determined by the OttLite Cobra and the LuxIQ/2, i.e each participant ill choose which lighting conditions is preferred for reading. The assessment tool (OTTLite Cobra or LuxIQ/2) which is performed first will be randomized for each participant. Microperimetry (a type of visual field test) will be conducted on all participants using the MAIA microperimeter at the NSU site only.
For subjects who do not appreciate an improvement in reading ability with a colored filter in office, we will obtain their written informed consent to include data collected during the clinical examination. For participants who do not appreciate an improvement in reading ability with a colored filter, but who appreciate an improvement in reading ability with white light as determined by the LuxIQ/2 in comparison to the OttLite Cobra, appropriate light bulb and desk lanp will be provided as determined by the LuxIQ/2. For participants who prefer the lighting determined using the Ottlite Cobra, they will be provided with an Ottlite Cobra desk lamp as well as their preferred settings on the device as determined through the in-office evaluation to be used at home. Participants to whom light bulb recommendations were provided or the Ottlite Cobra was recommended to improve lighting for their reading tasks, will be contacted by a research assistant 1 week after the in office assessment to complete a telephone interview which will consist of an Activity inventory questionnaire which will inquire about their difficulty performing near tasks using their previous light source as well as Ramulu's sustained reading test. The Ramulu sustained reading test will be performed twice during the phone interview, once with their previous lighting they were using at home before they obtained the new reading lamp (where they do most of their reading) and again with their new desk lamp. After 1 month, the research assistant will call the participant to repeat the Activity questionnaire inquiring about ability to perform near tasks using the new recommended lighting.
For participants who appreciate an improvement in reading ability with colored reading glasses, we will obtain their written informed consent to join the longer-term study.
* Reading materials will be provided to participants in an enclosed envelope in office. Participants will be asked to refrain from opening envelope until contacted by research assistant. Other individuals who decide to participate at a later time after contemplating the requirements of the research, will be sent the reading material in the mail.
* A research assistant will contact subject 1 week after in office assessment to complete telephone interview which will consist of the reading domain of the Activity Inventory questionnaire and the modified Telephone Interview of Cognitive Status (TICS-M) and silent reading test. During the call, subject will be asked to read several pages of a short story to themselves, silently using their current reading glasses, not the new ones that will be ordered. Subjects will be asked to answer a few questions about the stories. This call should take about 30-60 minutes.
* Subjects will be provided with new prescription clear reading glasses. After 1 month a research assistant will contact participant to repeat the same questionnaires and silent reading test using a different short story.
* Within a month after the phone questionnaires, the PI will make an appointment to come to the subject's home to test near vision and contrast sensitivity and determine preference for filter in home environment. At this time, the PI may ask for the new pair of clear reading glasses to take them to our optical to tint the lenses to the color that is preferred by the subject.
* One group will obtain near vision glasses with color filter/tinted lenses immediately, while the other group (controls) will continue to wear the clear reading glasses for another 4 weeks and will then will crossover to obtain near vision glasses with the filter/tinted lenses.
* About a month after wearing near reading glasses with the colored lenses, one of our research assistants will call participant to repeat the same questionnaires and silent reading test again using a different short story. This call should take about 30-45 minutes.
* At the end a low vision optometrist on the research team will contact participants to ask some open-ended questions about what the participant thought about using the near reading glasses with the colored lenses. This call should take about 15-30 minutes.
