Abstract
Purpose :
Dry eye patients commonly report functional disabilities such as reading and driving difficulty. The purpose of this prospective, observational study was to correlate the severity of clinically significant dry eye with self-reported driving performance.
Methods :
One hundred twenty subjects over the age of 50 were consecutively recruited. Dry eye symptoms were evaluated using the Ocular Surface Disease Index (OSDI) questionnaire. Objective measures of dry eye included automated tear film break-up time, Schirmer’s test without anesthesia, conjunctival lissamine green staining, corneal fluorescein staining, and tear osmolarity. Sjögren's International Clinical Collaborative Alliance registry staining schema was used to grade corneal (0-6) and conjunctival (0-3 nasal and temporal separately) staining, and added to obtain the total ocular staining score (OSS). Patients who met the criteria for clinically significant dry eye (defined as Schirmer’s score ≦10 and/or OSS ≥3) or control (no history or clinically significant dry eye) were included, all other patients were excluded. Subjects reported their current driving status, estimated number of miles per year, and if they drove at night or in unfamiliar areas.
Results :
74 patients with clinically significant dry eye and 16 controls were included in the analysis. Patients with dry eye reported driving fewer miles than controls (11033 versus 16083 miles/year, p=0.05). Decreased driving distance was associated with lower Schirmer’s scores (β= -144 miles/1 mm, p=0.08) and greater OSS (β=435 miles/1 point, p=0.10). Patients with severe dry eye, as determined by the presence of confluent corneal staining, reported a yearly driving average 4,390 miles lower than those without confluent staining (95%CI: -8738 to -41, p=0.04). Every one-point increase in the total OSDI score was associated with a decrease of 86.9 miles per year (95% CI: -166.1 to -7.8, p=0.03). For each incremental increase in dry eye severity (mild, moderate, severe, as determined by OSDI), individuals were 1.6 times less likely to drive at night or unfamiliar areas (95% CI: OR= 0.94 to 2.8, p=0.08).
Conclusions :
Quantitative indicators of dry eye, including Schirmer’s test and the presence of confluent corneal staining, are directly associated with driving restriction. Symptoms of dry eye, as measured by the Ocular Surface Disease Index questionnaire, also seem to be predictive of limitations in driving.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.