Impact of Dry Eye on Reading
Background/aims People with dry eye often complain of difficulty reading, but this perceived deficit has not been appropriately quantified. The purpose of this study is to determine if dry eye is associated with measurable reading deficits.
Methods A cross-sectional study of 1981 participants in the Salisbury Eye Evaluation, a population-based study of the elderly. Dry eye symptoms were identified by questionnaire and clinically significant dry eye was defined as the presence of dry eye symptoms and positive Schirmer testing or ocular surface staining in either eye. Spoken reading speed was measured using short text passages. Subjects self-reported if they did not read or had difficulty reading newsprint.
Results 13.8% of subjects (274/1981) had dry eye symptoms and 3.1% (62/1981) had clinically significant dry eye. There was no difference in reading speed between subjects with dry eye symptoms or clinically significant dry eye and their controls (p=0.99 and 0.78, respectively) in multivariable models. Compared with asymptomatic subjects, however, subjects with dry eye symptoms were more likely to report reading difficulty (OR=1.7, 95% CI 1.3 to 2.4, p<0.01) and not reading newsprint (OR=1.9, 95% CI 1.0 to 3.6, p=0.04). Similarly, subjects with clinically significant dry eye were more likely to report difficulty reading newsprint (OR=2.5, 95% CI 1.4 to 4.5, p<0.01) or not reading newsprint at all (OR=4.1, 95% CI 1.6 to 10.7, p<0.01) as compared with subjects without dry eye signs or symptoms.
Conclusions Dry eye did not significantly affect reading speed but was associated with self-reported reading difficulty and avoidance of newspaper reading in this elderly population-based sample.
Although often under-recognised and underappreciated, dry eye is a growing public health concern that affects as many as 17% of women and 11% of men in the USA. It can have a substantial impact on quality of life: dry eye symptoms are known to correlate with inability to work or perform activities of daily living and with poor scores on several vision-related quality of life measures.
Difficulty with reading is the most common and arguably the most significant functional complaint of individuals with dry eye and may contribute to lower quality of life. It is not yet clear, however, how dry eye impacts reading. Most prior research has used self-report data to evaluate reading difficulty in dry eye, which is important for gaining insight into perceived impairment. We hold that the best way to evaluate reading disability is with a comprehensive approach that includes self-report and direct observation of reading ability.
The Salisbury Eye Evaluation (SEE) is a population-based study of elderly residents of Salisbury, Maryland designed to assess the impact of eye disease and physical impairment on disability. SEE subjects were evaluated for dry eye symptoms and signs, and also had a comprehensive assessment of their reading, encompassing self-reported reading difficulty, reading habits and reading speed. Here, we compare reading function among asymptomatic subjects, individuals with dry eye symptoms and individuals with evidence of clinically significant dry eye.
Abstract and Introduction
Abstract
Background/aims People with dry eye often complain of difficulty reading, but this perceived deficit has not been appropriately quantified. The purpose of this study is to determine if dry eye is associated with measurable reading deficits.
Methods A cross-sectional study of 1981 participants in the Salisbury Eye Evaluation, a population-based study of the elderly. Dry eye symptoms were identified by questionnaire and clinically significant dry eye was defined as the presence of dry eye symptoms and positive Schirmer testing or ocular surface staining in either eye. Spoken reading speed was measured using short text passages. Subjects self-reported if they did not read or had difficulty reading newsprint.
Results 13.8% of subjects (274/1981) had dry eye symptoms and 3.1% (62/1981) had clinically significant dry eye. There was no difference in reading speed between subjects with dry eye symptoms or clinically significant dry eye and their controls (p=0.99 and 0.78, respectively) in multivariable models. Compared with asymptomatic subjects, however, subjects with dry eye symptoms were more likely to report reading difficulty (OR=1.7, 95% CI 1.3 to 2.4, p<0.01) and not reading newsprint (OR=1.9, 95% CI 1.0 to 3.6, p=0.04). Similarly, subjects with clinically significant dry eye were more likely to report difficulty reading newsprint (OR=2.5, 95% CI 1.4 to 4.5, p<0.01) or not reading newsprint at all (OR=4.1, 95% CI 1.6 to 10.7, p<0.01) as compared with subjects without dry eye signs or symptoms.
Conclusions Dry eye did not significantly affect reading speed but was associated with self-reported reading difficulty and avoidance of newspaper reading in this elderly population-based sample.
Introduction
Although often under-recognised and underappreciated, dry eye is a growing public health concern that affects as many as 17% of women and 11% of men in the USA. It can have a substantial impact on quality of life: dry eye symptoms are known to correlate with inability to work or perform activities of daily living and with poor scores on several vision-related quality of life measures.
Difficulty with reading is the most common and arguably the most significant functional complaint of individuals with dry eye and may contribute to lower quality of life. It is not yet clear, however, how dry eye impacts reading. Most prior research has used self-report data to evaluate reading difficulty in dry eye, which is important for gaining insight into perceived impairment. We hold that the best way to evaluate reading disability is with a comprehensive approach that includes self-report and direct observation of reading ability.
The Salisbury Eye Evaluation (SEE) is a population-based study of elderly residents of Salisbury, Maryland designed to assess the impact of eye disease and physical impairment on disability. SEE subjects were evaluated for dry eye symptoms and signs, and also had a comprehensive assessment of their reading, encompassing self-reported reading difficulty, reading habits and reading speed. Here, we compare reading function among asymptomatic subjects, individuals with dry eye symptoms and individuals with evidence of clinically significant dry eye.