AB004.The dyslexia font OpenDyslexic facilitates visual processing of text and improves reading comprehension in adult dyslexia

Background:Proficient literacy skills and reading comprehension are crucial skills for participation and success in everyday life.One group that regularly falls short in demonstrating good reading skills are people with dyslexia.This group suffers from a range of visual deficits including the pattern of ocular movements,and distorted,blurred and reversed(or mirrored)vision of letters during reading.However,only recently designers started to develop affordable and easily implementable remedies that are supposed to reduce the visual symptoms of dyslexia such as specific dyslexia fonts.These fonts incorporate properties aimed at improving the visual and behavioural reading performance of people with dyslexia by using larger intra-and inter-word whitespace,unique letter shapes and no serifs.To date,empirical evidence about the efficacy of these fonts is contradictory,and their effects on adult dyslexics’eye movements and cognitive processing during longer reading tasks remains elusive.Methods:To bridge this gap,we measured the eye movements of adults with and without dyslexia during the reading of a set of standardised texts from the international reading speed texts(IReST;Trauzettel-Klosinski&Dietz,2012)reading battery coupled with validated comprehension questions.These texts and questions were presented either in the traditional font Times New Roman or the specific dyslexia font OpenDyslexic.Results:Here,we found that OpenDyslexic led to improvements in reading comprehension in dyslexics and non-dyslexics.These improvements were larger for dyslexics.Contrarily,participants’reading speed was unaffected by OpenDyslexic.Our eye-tracking data showed that OpenDyslexic resulted in a higher number of eye movements,reduced visual search intensity,and longer median fixation duration across participants.Particularly,median fixation duration,as a measure of cognitive load,was predictive of reading comprehension across groups.Among dyslexics,OpenDyslexic yielded increases in visual search intensity and visual ease in the form of decreases in median fixation duration and fixation to saccade ratio as well as a smaller number of falsely programmed forward saccades.Conclusions:Our findings illustrate that OpenDyslexic results in a different visual reading strategy.These findings provide empirical evidence for the efficacy of OpenDyslexic in longer standardised texts and suggest its use in everyday documents,education materials,and online sources.

AB105.Database of retinal images in visually impaired individuals:drusen and age-related macular degeneration(AMD)

Background:With a large portion of older adults living longer,the number of individuals diagnosed with low vision is increasing.The use of optical coherence tomography/scanning laser ophthalmoscope(OCT/SLO)to diagnose retinal disease has become common place in the last 10 years,yet currently there are no OCT/SLO databases for pathological vision.Our aim is to develop a clinical database of individuals who have drusen(i.e.,lipid deposits found under the retina),or have been diagnosed with age-related macular degeneration(AMD),with information as to how the structure of the diseased retina changes over time,as well as measures of visual and cognitive functional performance.Methods:Fundus photographs and retinal scans will be taken using the same model of optos OCT/SLO located in three test sites(MAB-Mackay Rehabilitation Centre,School of Optometry Clinic at the University of Montreal,and the Lighthouse Institute,New York,USA).For each individual entry in the database,demographic and diagnosis information will be available.All OCT/SLO images will be graded according to the Age-related Eye Disease Study standard,in addition to number and size of drusen,severity of geographic atrophy,severity of pigment mottling and presence of choroidal neovascularization.Retinal topography and Raster scans from the OCT/SLO will provide a cross-sectional look at affected retinas.Fixation stability will be recorded using the SLO function,and present four different tasks that are designed to reproduce typical tasks of daily vision,with each task lasting for 10 seconds.The tasks are cross fixation,face recognition,visual search,and reading.These tasks in addition to the retinal scans will be used to determine the eccentricity of a preferred retinal locus from the anatomical fovea,and can be used as an outcome measure for clinical interventions in visually impaired patients.Results:The database will be available to professors training eye-care practitioners and rehabilitation specialists as a teaching tool.Students will be able to familiarize themselves with the retina and a variety of AMD-related pathologies before they start working with patients.The database will also be accessible by researchers interested in studying AMD from basic science to epidemiology,to investigate how drusen and AMD impact visual and cognitive functional performance.Conclusions:The common infrastructure is easily accessible to all VHRN members on request.The database will also be accessible online in 2018(see http://cvl.concordia.ca for more information).

AB036.An interview based assessment’s sensitivity and specificity for identifying dual vision and hearing loss in older adults with and without risk of Mild Cognitive Impairment

Background:Dual vision and hearing loss or dual sensory impairment(DSI)negatively impacts a person’s ability to communicate,acquire information,and perform daily activities.Because the incidence of DSI is higher in older adults(65+),and the fact that most developed countries are aging,there is expected increase in DSI prevalence.The detection and evaluation of DSI is of utmost importance because several aspects of health care delivery,and communication with health professionals,depend on it.Identifying DSI in older adults can be more difficult when they present with mild cognitive impairment(MCI),which may limit their ability to report sensory loss,potentially resulting on medical professionals failing to detect DSI.The interRAI CHA is the only standardized interview instrument for adults(18+)that helps first-line health care providers to identify and assess DSI.This study evaluated this instrument’s sensitivity and specificity for detecting vision and or hearing loss in older adults with and without risk of MCI.Methods:The study sample consisted of 200 adults aged 64+that were receiving rehabilitation services for either vision loss only,hearing loss only,or DSI.Two measurements were collected:(I)interRAI CHA,which consists of roughly 150 closed-ended questions,two of which are used to identify DSI;(II)Montreal Cognitive Assessment(MoCA),a 10-minute screening test that assess cognitive function and identifies individuals at risk of MCI.The interRA CHA sensitivity and specificity for identifying DSI was calculated in comparison to gold standard objective measurements of vision and hearing obtained from participants’medical records.Sensitivity and specificity results were stratified based on risk of MCI,as assessed by the MoCA.Results:Sensitivity for DSI was slightly better for respondents that were not at risk of MCI(97.4%)compared to those who were at risk of MCI(96.2%).Likewise,sensitivity for HL only was slightly better for respondents that were not at risk of MCI(97.4%)compared to those who were at risk of MCI(96.8%).Because sensitivity was 100%for VL only,the potential impact of MCI risk on the interRAI CHA’s sensitivity for detecting VL only cannot be studied in this sample.Specificity for DSI and HL were higher for participants not at risk of MCI(HI:96.2%,DSI:94.8%),compared to those at risk of MCI(HI:90.2%,DSI:91.1%).Dissimilar to this,in the VI group specificity was slightly better in participants at risk of MCI(100%),compared to those not at risk of MCI(98.7%).This was due to a single participant not at risk of MCI who was not classified as VL by the medical record,yet did report difficulties with vision when responding to the interRAI CHA question on vision.Conclusions:The interRAI CHA’s sensitivity and specificity for detecting DSI was lower for older adults at risk of MCI,compared to those not at risk of MCI.Future research should investigate strategies to improve identification of DSI in persons at risk of MCI.

AB034. Knowledge and understanding of eye disease among older adults with vision impairment

Background:By 2026,projections indicate that 1/5 Canadians will be over the age of 65.This shift in demographics will be accompanied by an increase in age-related eye disease.Survey studies have reported vision loss as a major medical concern among older adults,but there is little information on older adults’awareness and knowledge of age-related eye diseases.A lack of knowledge can lead to missed or delayed treatment and/or lifestyle modification.This study aims to assess the knowledge and understanding older adults have of their own eye disease and its prognosis.Methods:Participants over the age of 50 with a visual impairment were recruited from the MAB-Mackay Rehabilitation Centre,the Low Vision Self-Help Association(LVSHA)of the West Island and through word of mouth.Visual acuity and contrast sensitivity were measured using the ETDRS charts and Mars Charts,respectively.Optical coherence tomography(OCT)/scanning laser ophthalmoscopy was used to take cross-sectional images of participant retinas.Participants were asked to name their visual diagnoses and describe them in their own words.Participant diagnoses were compared to diagnoses determined by an optometrist or ophthalmologist.Results:To date,this study has recruited 26 participants(7M,19F)over the age of 50 years(range,51-95 years).Many participants(73%)were able to name their visual diagnoses,articulate their symptoms,and discuss their treatment and prognosis.The majority of these individuals(67%)were clients of the MAB-Mackay or participants in the LVSHA.Of the 27%(4M,4F)who were unclear or had misunderstood their diagnoses,half were participants in a low vision support group,but they had multiple visual diagnoses and it was the congenital or trauma-related visual impairments acquired before joining the MAB-Mackay or LVSHA that remained unclear.The other 4 individuals who misunderstood their diagnoses were not involved with any low vision or rehabilitation organizations.Conclusions:Visual impairment is sometimes dismissed as part of aging.A lack of awareness and knowledge can lead to missed or delayed treatment and/or lifestyle modifications.The preliminary results of this study demonstrate the important role organizations like the MAB-Mackay and LVSHA play in education and adaptation to low vision for older adults.Individuals with a better understanding of their own diagnoses are more likely to follow through with doctor-recommendations and have successful treatment or slowed progression.

AB008. The impact of affect on environmental scene perception

Background:The environment that individuals are surrounded by have been linked to have an effect on affect,like anxiety,and well-being.On a whole,rural and natural environment scenes have been showed through previous research to increase positive affect and well-being.Until now,the methods of assessing affect in relation to environmental scene perception have been studied in a healthy sample,and mostly via self-report questionnaires and heart rate.Here,we present a novel quantitative research study that uses frontal electroencephalography(EEG)asymmetry to investigate the impact of viewing images of environmental scenes on affect in a sample of self-reported sub-clinically anxious adults.Frontal EEG asymmetry has previously been used in research related to motivation and assessing emotional affect,with most researchers showing greater left-frontal hemisphere activity compared to the right being associated with positive affect and approach behaviours.Consequently,frontal asymmetry EEG can be used to explore the impact of scene perception on affect.Methods:Forty-six participants(18-52 years)took part in the study.To determine the psychophysiological predictors of affect,specifically anxiety,we monitored brain activity using EEG,while participants viewed a series of natural and man-made images on a computer screen.Natural images consisted of beaches,forests,meadows,mountains,waterfalls.Man-made images consisted of cityscapes,construction sites,highways,skyscrapers and street views.EEG was Fourier transformed,and the alpha-band frequencies(8-12 Hz)isolated and averaged across each image type.Results:Preliminary analysis of frontal-asymmetry shows that individuals with sub-clinical levels of anxiety experience significantly more negative affect(i.e.,increased right asymmetry in alpha bands,(M=−3.15,SD=0.63)when viewing man-made images compared to control participants(M=−1.02,SD=0.67).These preliminary results contrast to when viewing natural images,whereby both controls and the anxious individuals experience high levels of positive affect(i.e.,increased left asymmetry in alpha bands:(Manxiety=3.31,SDanxiety=2.26;Mcontrol=3.33,SDcontrol=1.12).Lastly,frontal-asymmetry indices were significantly different(t=17.48,P<0.001,d=2.58,BF10=3.81e+18)when viewing natural and man-made images.This result was consistent across both groups.Conclusions:This research presents a novel approach to investigating the neuro-cognitive correlates of affect and scene perception.Additionally,these initial observations would indicate that man-made scenes induce negative affect,and that this effect is amplified in individuals with sub-clinical levels of anxiety.Future work should expand this research to investigate environmental scene perception in individuals with clinical levels of anxiety,and use other physiological measures,such as heart-rate variability and eye-tracking to objectively assess affect.

AB103.Comparative study on the actual lighting assessment method and the use of a standardized tool(LuxIQTM)

Background:With the arrival of a new standardized tool and considering the multiple disadvantages of the actual method used for assesses lighting needs,the goal of the study was to compare the actual lighting assessment method used by the clinicians working in a rehabilitation center with the use of the LuxIQTM.As reading is found to be the main difficulty mentioned by the majority of the clients at the rehabilitation centre and that past studies have shown the impact of lighting on improving reading speed and deceasing print size,the hypothesis stated that the use of the standardized tool would be statistically significantly superior than the use of the standard method on the variables on reading speed,print size,ocular fatigue,application of the recommendations and satisfaction of the length of time read.Methods:Three clinicians proceeded to home lighting assessments for 28 participants aged from 19 to 100 years(mean=75,SD=27)old diagnosed with age-related macular degeneration or glaucoma.The study evaluated and compared pre and post results between the two methods.Results:The intervention did not have a statistically significant impact on any of the variables mentioned.The lighting assessment itself,with either the standard method or using the LuxIQ,statistically significantly decreased print size for reading(P<0.001,ω2=0.47).Conclusions:Lighting has a significant impact on reading print size.Participants value the assessment but encounter various obstacles that prevent them from applying the lighting recommendations.Considering the positive impact of lighting,finding a solution so participants may profit from the benefits of this intervention is crucial.

AB097.Barriers and facilitators related to the use of optical low vision aids,a scoping review

Background:In recent decades,several studies have been performed in the field of(non-)use of assistive technology devices(ATs)and have found that many variables are likely to be involved in the decision-making process of whether a person with a disability uses or abandons their aids.In low vision rehabilitation,high variability rates and a variety of reasons for non-use of low vision aids has been reported.Determinants of non-use of ATs have previously been categorized into personal factors,ATs factors,environmental factors of the user,and intervention factors.It is probable that some of these factors are also associated with the use of optical low vision aids(OLVAs).Thus,using a framework about adherence with medical interventions,the aim of this scoping review was to explore barriers and facilitators related to OLVAs(non-)use.Methods:Existing guidelines of the scoping review Methods were used to examine and summarize the extent,range,and nature of findings regarding factor categories associated to OLVAs usage.Searches were conducted using the following online databases:Embase,MedLine,and ERIC without limitation on publication dates.A combination of key words and MeSH terms was used based upon the identified core concepts of the research question:(I)low vision;(II)assistive technology;and(III)adherence.A charting form,a flow chart of the study selection process,and a combination of a descriptive numerical analysis and a thematic analysis of 24 studies were performed.Results:The results of this review indicate high variability rates(range:13-50%,M=24%,SD=10%)of people possessing OLVAs but not using them.Most authors do not use a precise definition of“non-use”,and when a definition is provided,the terminology is inconsistent.As expected,the four categories of variables identified are likely to be involved in OLVAs’(non-)use:(I)the largest number of concerns were personal factors.Several aspects regarding personal characteristics were identified,such as demographic,physical,psychological,social-emotional,and occupational factors.Some variables,such as age,diagnosis and visual acuity were reported as contradictorily influencing the OLVAs’usage;(II)ATs factors were associated with quality,appearance,practical aspects of use and the very type of OLVAs;(III)environmental factors referred to social support,physical barriers,expectations of the social environment,presence of a helper,and stigmatization;(IV)finally,intervention factors consisted of taking into account user’s opinions,positive health care experiences,instruction and training,provision processes,delivery periods,and follow-up services.Conclusions:This scoping review provides the preliminary evidence that factors related to OLVAs non-use could be classified into the same four typical categories described in the theory of non-adherence.These results suggest that strategies intended to enhance adherence might be for OLVAs should focus on these four aspects of device use.

AB104.Validation of the international reading speed texts in a Canadian sample

Background:The International Reading Speed Texts(IReST)were developed in Europe as a standardized measure to assess continuous reading in normally sighted and visually impaired individuals.The IReST is used throughout the United States and Canada to assess reading speed;however,the normative values may not be valid in North America(NA).Additionally there are no normative values for individuals with visual impairments.The aim of this study was to validate the IReSTs in a normally sighted English-speaking NA sample with and without a simulated reduction in visual acuity.Methods:Fifty undergraduate students from Concordia University participated in this study.Participants were systematically assigned to a counterbalanced order of testing conditions and were asked to read all 10 IReSTs aloud.The normal and impaired vision conditions were counterbalanced such that the first set of five IReSTs were read with either the participants normal/corrected-to-normal vision or with a simulated 20/80 visual impairment.Results:Multiple two-sample dependent t-tests using a Holm-Bonferroni correction for multiple comparisons were used to compare the IReST values(means and standard deviations)to the current sample;the results showed statistically significant differences between the current samples mean reading speed and the values provided by the IReSTs.In all cases,P were equal to or less than 0.005.Mean difference scores ranged from 14.87 to 30.05 wpm,with 95%confidence intervals ranging from 4.82 to 43.32.Measures of effect size using bias corrected Hedge’s g*ranged from 0.83 to 1.32,with 95%confidence intervals ranging from 0.25 to 1.93.Multiple two-sample dependent t-tests using a Holm-Bonferroni correction for multiple comparisons were used to compare the mean reading speed in wpm of the normal and impaired vision conditions;the results showed statistically significant differences between the mean reading speeds of the normal vision condition and the simulated impairment condition on the IReSTs.In all cases,the P were less than 0.001.Mean difference scores ranged from 25.44 to 41.8 wpm,with 95%confidence intervals ranging from 21.66 to 46.Measures of effect size using bias corrected Hedge’s g*ranged from 2.74 to 3.81,with 95%confidence intervals ranging from 1.97 to 4.74.Further Bayesian analyses revealed BF10 factors ranging from 1.277×107 to 7.334×1011,indicating decisive evidence for the research.Conclusions:There are statistically significant differences in reading speed between the NA English sample and the normative values established by the IReST;such that reading speeds of the NA English sample are slower than the normative values of the IReST.Additionally,participants in the simulated impairment condition read the IReSTs significantly slower than the normal vision condition.

AB098.Perceptual,motor and cognitive factors related to braille reading performance in aging:a scoping review

Background:A growing number of older adults with vision loss require vision rehabilitation services to address reading difficulties.Braille may be the most appropriate option for those with functional blindness,poor visual prognoses or dual sensory loss.While standardized braille assessment and training protocols are in place to guide interventions with children,there is a high degree of inconsistency and a lack of evidence-based knowledge about best practices to use with adults and seniors who require braille training.Age-related declines in tactile acuity,motor dexterity and cognition present unique barriers to braille training,but very little is known about the impact of aging on factors related to braille reading performance.The aim of this scoping review is to identify the perceptual,motor,and cognitive factors related to braille reading performance and to determine how these factors have been assessed or measured among blind adults and elderly individuals in prior studies.Methods:Using the scoping review method,a comprehensive search was conducted in three databases:PubMed,Educational Resource Information Center(ERIC),and the Cochrane library.Two reviewers screened articles for inclusion to ensure internal agreement,based on identified exclusion criteria.Results:The initial search resulted in 1,565 qualitative and quantitative articles.The results synthesize the perceptual,motor and cognitive factors known to predict braille reading performance,how these variables are impacted by the aging process,and how they have been measured in prior studies.Conclusions:This scoping review is the first step in working towards the development of evidence-based assessment and training protocols to standardized practice with adult and senior clients who require braille training.It also serves to clarify where current knowledge gaps exist in order to guide future studies on braille reading and aging.

AB096.Neurophysiological measures of stigma stereotypes

Background:The perceptions surrounding assistive technology have been shown to be increasingly stigmatizing in older adult populations.This stigmatization can lead individuals to the abandonment of the assistive device.Until now,the methods of identifying or predicting the stigma surrounding assistive technology has mostly been qualitative in nature.Here we present a novel quantitate and qualitative research study that uses neuro-cognitive(psychophysics and EEG)and eye tracking technology,in addition to a new questionnaire to investigate the stigma associated with assistive devices.Therefore,this approach plays a major role in understanding and predicting the neural and physiological correlates associated to stigma.Methods:Thirty-four older adults(>50 years)took part in the study.To determine the psychophysiological predictors of stigma surrounding assistive technologies,we monitored brain activity using EEG,heart rate and eye movements using an eye-tracker while participants viewed a series of images containing either an older or younger individual in different social scenarios(e.g.,talking to doctor,at coffee shop).In each scenario,the individual uses either no assistive device,a low stigmatizing device(e.g.,iPad),or a high stigmatizing device(e.g.,electronic magnifier).Results:Here we present preliminary analysis of the eye movement data.Analysis shows that in comparison to images that contained a low stigmatizing device,in images that contain high stigmatizing devices,the latency to fixate the device is shorter,first fixation duration is longer,and the total number of fixations on the device are higher.The environment that the devices is used in has no effect on eye movement metrics.Conclusions:Although the sample size is small,and based on a healthy older-adult population,these initial observations would indicate that latency to fixate and first fixation duration are predictors of stigma associated with assistive devices.Future research should expand this prediction to those actively using assistive devices,and how the measures predict abandonment over time.

AB100.Screening for vision and hearing loss in patients with dementia:recommendations from interviews with sensory experts

Background:Dementia is a syndrome that affects a person’s ability to understand and express information.The higher prevalence of vision and/or hearing losses among persons with dementia in long-term care(LTC)facilities interferes with the ability of nurses to provide optimal care because communication is compromised.Therefore,the detection and screening for sensory impairment is of the utmost importance in LTC facilities;however,there is currently no agreement among nursing professionals on how to best identify such losses for the purpose of further referral,and the need for a validated screening measure suitable for nurses in LTC facilities is clear.The present project aims to close this gap by investigating the screening recommendations of vision-and hearing-care professionals working with clients affected by dementia.Methods:Eleven experts in audiology,optometry,deafblindness,and technology participated in individual semi-structured interviews on the topic of tools and strategies that can be used to screen individuals with dementia for sensory loss.Interview transcripts were coded by two evaluators using verbal agreement and consensus building.Results:Three main themes emerged from the interviews with experts:barriers,facilitators,and strategies.Barriers to sensory screening were often mentioned,particularly impaired communication and lack of staff cooperation.Facilitators consisted uniquely of people,such as family members,intervenors,and nurses.Strategies for sensory screening in this population consisted of improving communication through repetition and encouragements;considerations based on familiarity;and inferring an impairment on the basis of patient behaviour.Few of our interviewees were knowledgeable on the topic of screening apps.Conclusions:Our findings,to be integrated with a similar environmental scan conducted among LTC nurses,can inform the administration of sensory impairment screening tests among a population with dementia in order to optimize care.

AB106. ORVIS: a directory of tools for vision rehabilitation

Background:The ORVIS infrastructure aims to facilitate the development and availability of valid and adapted tools that will allow functional,perceptual,cognitive and psychological evaluation of low vision clients by researchers and clinicians who work in low vision and visual impairment rehabilitation.Methods:The tools developed or documented within ORVIS Infrastructure are tests or questionnaires which allow,or will allow to assess-in an accurate and reliable manner-characteristics related to visual impairment.The tools in development are:(I)questionnaire de repérage des hallucinations visuelles liées au syndrome de Charles-Bonnet(QR-SCB);(II)repérage des personnesâgées présentant des INDices de déficience VISUELle(IndiVisuel);(III)mesure de l’impact de la déficience visuelle dans les activités quotidiennes(MIDVAQ)and(IV)M’EYE read test.The directory documents 14 tools and offers-within a descriptive sheet-characteristics,components and metrological properties as supported by cited scientific studies.Results:The ORVIS Infrastructure,which aims at the development and availability of assessment tools,fills researchers’and clinicians’needs for measurement tools that are valid,effective and appropriate for use with a visually impaired clientele.Such tools are,especially in French,little known and hard to find,and represent a precious resource for those who want to evaluate the efficacy of treatments or interventions.Conclusions:ORVIS is available at www.orvis.vision.Between November 2015 and September 2017,the directory has been accessed 1,383 times by 952 unique visitors.

AB101.Portable closed-circuit TV versus iPad in spot reading tasks

Background:Spot reading,the ability to obtain short pieces of visual information,can easily be rehabilitated with magnification devices,such as loupes or portable closed-circuit TVs(CCTVs).However,they have limitations such as screen size and price and have previously been shown to be stigmatizing when used in public.The arrival of tablet computers provides an alternative with greater magnification at a reduced price.We present preliminary results on the objective and subjective comparison of the iPad and a portable CCTV for spot-reading tasks.Methods:Twenty-three men and 30 women aged 19-93 years,with impaired visual acuity(<20/60)due to central visual impairment,were asked to complete spot-reading tasks involving three common objects(TV cable bill,nutrition info on food package,box of eye drops)using the iPad and a portable CCTV in randomized order.We measured their ability to complete each task and the time it took,in addition to their subjective device assessment and preference.Results:A Bayes Factor and effect size analysis showed no statistically significant differences between the device conditions in the time to complete each task[BF01>4.05,median=−0.043,95%credible interval(−0.21,0.234)].Choosing one device over the other may simply depend on preference which,in our cohort,was divided(39.6%iPad,56.6%CCTV,3.8%neither)and which could be influenced by factors such as device size,usability or stigmatization.Conclusions:The data indicate that,for certain spot reading tasks and levels of difficulty,the use of a tablet computer may be as efficient and effective as a traditional device such as a portable CCTV.Future investigations will further examine device preference as we predict that it may influence device success and continuation of use.