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George W Ousler, John David Rodriguez, Lisa Smith, Keith Jeffrey Lane, Colleen Heckley, Endri Angjeli, Donna L Welch; Optimizing reading tests for dry eye. Invest. Ophthalmol. Vis. Sci. 2014;55(13):160.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate reading tests as clinically meaningful assessments of visual function in dry eye patients.
Fifteen dry eye subjects (mean 65 years, SD 11.71) and 10 normal subjects (mean 40 years, SD 12.61) participated in this study. An age-matched subgroup of 5 normal (mean 51 years, SD 5.90) and 7 dry eye (mean 53 years, SD 3.65) subjects were also analyzed. Reading tests included the Wilkins test and the International Reading Speed Texts (IReST), as well as the IReST presented at critical print size. A menu reading test was also included. Symptoms assessed included ocular discomfort as well as an evaluation of subjective fatigue state. Blink rate and the presence/absence of self reported reflex tearing during each test was also recorded.
Reading rate in words per minute was significantly lower in all reading tests for the dry eye group relative to the control group. These results were consistent in the age-matched subgroup, with only the menu reading test failing to achieve statistical significance (Wilkins, p=0.0237; IReST, p=0.0064; IReST at critical print size, p=0.0033). The presence of self-reported reflex tearing during testing significantly decreased reading rate of dry eye subjects during the Wilkins test (p=0.02). Blink rate, baseline symptoms, and demographics were not significantly correlated with reading test results.
The results of this study demonstrate that dry eye subjects have slower reading rates when compared to normals, confirming previous studies (Ridder, 2013). Additionally, reflex tearing during visual tasking adversely effects reading performance in dry eye subjects. Reading tests are effective clinical tools to differentiate between dry eye and normal subjects, and may represent a valuable, patient-oriented outcome measure for use in the development of new dry eye therapies.
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