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Michael Watson, Keith Jeffrey Lane, Colleen Heckley, John David Rodriguez, Lisa Smith, Endri Angjeli, Donna L Welch, George W Ousler; Reading difficulty questionnaire administered to dry eye subjects. Invest. Ophthalmol. Vis. Sci. 2014;55(13):1997.
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To define the reading difficulties experienced by dry eye subjects.
From a pool of 159 subjects who had participated in a prior dry eye clinical trial, 120 were identified who had responded with at least a score of 1 (“some of the time”) to the reading problems question of the Ocular Surface Disease Index (OSDI) questionnaire. Of these, 34 patients completed a customized questionnaire that explored reading difficulty in eight domains (including format, severity, and frequency). Questions were both open-ended (to allow for spontaneous responses) and forced-choice.
Driving at night, reading at night, and computer use were most affected by dry eye. Computer (76.4%) and newspaper (73.5%) formats were cited as the most problematic for dry eye patients and given a 3 on a 0-5 point scale. Burning/stinging were confirmed as the most frequent symptom complaint while reading, followed by blurriness, dryness, light sensitivity, and grittiness. Increased urge to blink was the most frequently reported response to reading difficulties (73.5%), followed by an urge to close the eyes (64.7%). Reading difficulty progressively worsened throughout the day. The most significant triggers of exacerbation were wind/air and fatigue. The most frequent behavioral modification for improving reading ability was artificial tear use (in only 10/34 subjects). Other effective changes were flushing eyes with water and wearing spectacles.
The questionnaire identified several key findings associated with reading difficulties in dry eye subjects: 1) Wind and air appear to be primary triggers for reading difficulty in dry eye subjects; 2) Reading difficulty becomes progressively worse during the day with greatest severity seen in the evening; 3) The frequent report of an ‘urge to blink’ and “blurred vision” in patients who were known to have reading difficulty was clinically meaningful. This questionnaire, in conjunction with objective measures of visual function, such as the interblink inverval visual acuity decay (IVAD) test (Torkildsen, 2009), is a useful tool in the evaluation of an agent’s ability to improve visual function.
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