Impact of the Ability to Divide Attention on Reading Performance in Glaucoma

Purpose To determine if the ability to divide attention affects the relationship between glaucoma-related vision loss and reading speed. Methods Better eye mean deviation (MD), contrast sensitivity (CS), and better-eye distance visual acuity (VA) were measured in 28 participants with glaucoma and 21 controls. Reading speeds were assessed using MNRead, IRest, and sustained silent reading tests (words per minute, wpm). The ability to divide attention was measured using the Brief Test of Attention (BTA; scored 0-10). Multivariable linear regression models were used to determine the relationship between visual factors and reading speeds. Effect modification by BTA score (low BTA: <7; high BTA: ≥7) was examined. Results Worse CS (per 0.1 log unit) was associated with slower maximum reading speed on MNRead test for participants with low BTA scores (β = -9 wpm; 95% confidence interval [CI]: -16, -2), but not for those with high BTA scores (β = -2 wpm; 95% CI: -6, +2). Similarly, for the IRest test, worse CS was associated with slower reading speeds (β = -12 wpm; 95% CI: -20, -4) among those with low, but not high BTA scores (β = -4 wpm; 95% CI: -10, +2). For the sustained silent reading test, glaucoma status (versus controls), worse visual field (VF) MD (per 5 dB), and worse CS were associated with 39%, 21%, and 19% slower reading speeds, respectively, for those with low BTA scores (P < 0.05), but these associations were not significant among those with high BTA scores (P > 0.1 for all). Conclusions Decreased ability to divide attention, indicated by lower BTA scores, is associated with slower reading speeds in glaucoma with reduced CS and VF defects.