title: Functional impairment of reading in patients with dry eye.
abstract: To evaluate the impact of dry eye on reading performance.
  
  
  
  Out-loud and silent reading in patients with clinically significant dry eye (n=41) and controls (n=50) was evaluated using standardised texts. Dry eye measures included tear film break-up time, Schirmer's test and corneal epithelial staining. Symptoms were assessed by the Ocular Surface Disease Index (OSDI).
  
  
  
  The dry eye group had a greater proportion of women as compared with the control group but did not differ in age, race, education level or visual acuity (p≥0.05 for all). Out-loud reading speed averaged 148 words per minute (wpm) in dry eye subjects and 163 wpm in controls (p=0.006). Prolonged silent reading speed averaged 199 wpm in dry eye subjects versus 226 wpm in controls (p=0.03). In multivariable regression models, out-loud and sustained silent reading speeds were 10 wpm (95% CI -20 to -1 wpm, p=0.039) and 14% (95% CI -25% to -2%, p=0.032) slower, respectively, in dry eye subjects as compared with controls. Greater corneal staining was associated with slower out-loud (-2 wpm/1 unit increase in staining score, 95% CI =-3 to -0.3 wpm) and silent (-2%, 95% CI -4 to -0.6 wpm) reading speeds (p<0.02 for both). Significant interactions were found between OSDI score and word-specific features (longer and less commonly used words) on out-loud reading speed (p<0.05 for both).
  
  
  
  Dry eye is associated with slower out-loud and silent reading speeds, providing direct evidence regarding the functional impact of dry eye. Reading speed represents a measurable clinical finding that correlates directly with dry eye severity.
authors.affiliation: The Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Priya M
authors.initials: PM
authors.lastname: Mathews
authors.affiliation: The Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Pradeep Y
authors.initials: PY
authors.lastname: Ramulu
authors.affiliation: The Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Bonnielin S
authors.initials: BS
authors.lastname: Swenor
authors.affiliation: The Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA.|Department of Ophthalmology, Dokuz Eylul University, Izmir, Turkey.
authors.forename: Canan A
authors.initials: CA
authors.lastname: Utine
authors.affiliation: Institute of Ophthalmology, University College of London, London, UK.|Biomedical Research Centre for Ophthalmology, London, UK.
authors.forename: Gary S
authors.initials: GS
authors.lastname: Rubin
authors.affiliation: The Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA.
authors.forename: Esen K
authors.initials: EK
authors.lastname: Akpek
mesh_terms: D000368:Aged; D015352:Dry Eye Syndromes / Q000503:physiopathology*; D005133:Eye Movements / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D011932:Reading; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013647:Task Performance and Analysis; D014787:Vision Tests / Q000379:methods; D015354:Vision, Low / Q000503:physiopathology*; D014792:Visual Acuity
keywords: Ocular surface; Vision