Reading with optical magnifiers: page navigation strategies and difficulties

PURPOSE: To read efficiently with a simple hand or stand magnifier, people with visual impairment have to move (navigate) the device along each line (forward phase) and back to the correct position at the start of the next line (retrace phase). Page navigation difficulties have been implicated as limiting factors when reading with hand and stand magnifiers, but have not been objectively measured. METHODS: Magnifier movements were recorded using a 3SPACE Isotrak system for 43 participants with age-related macular degeneration (AMD) who read two short stories using their habitual hand or stand magnifier. Page navigation was quantified in terms of magnifier movements and navigation errors for the forward and retrace phases. Visual acuities and visual fields were measured, and magnifier usage and page navigation difficulties were surveyed. RESULTS: During the forward phase, participants primarily used either a straight (47%) or diagonal downward (46%) movement, whereas during the retrace phase, the majority (56%) used a downward movement. On average, forward navigation time was four times longer than retrace navigation time (p