• Prolonged Reading Worsens Dry Eye Symptoms

    By Lynda Seminara
    Selected By: Stephen D. McLeod, MD

    Journal Highlights

    Ophthalmology, October 2018

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    Karakus et al. studied the effects of prolonged silent reading on tear film and ocular surface parameters. They found that symptoms of dry eye disease (DED) provoked by everyday tasks, such as reading for pleasure or work, often go undetected during clinical testing.

    This prospective observational study included 177 patients with DED and 34 normal controls, all of whom were at least 50 years old. After symptom evaluation with the Ocular Surface Disease Index (OSDI) questionnaire, the following tests were performed in consecutive order: automated noninva­sive tear breakup time (TBUT), surface asymmetry and regularity indexes, Schirmer test (without anesthesia), corneal staining using fluorescein, and conjunctival staining using lissamine green. The participants then completed a standardized validated task consisting of reading a 7,200-word story for at least 30 minutes.

    The same tests were repeated after the reading exercise, and the researchers documented differences in the 2 sets of test results.

    After the reading task, all test results were poorer in both study groups, except for the surface asymmetry index. The worsening was significant for corneal and conjunctival staining in the DED group and for cor­neal staining in the control group.

    At baseline, OSDI correlated only with scores for corneal staining and conjunctival staining. Among the measurements taken after reading, baseline OSDI correlated with TBUT and with scores for corneal staining and conjunctival staining. Changes in TBUT and Schirmer test findings correlated strongly with their respective baseline values, indicating that patients with greater tear film instability and lower aqueous tear se­cretion are more susceptible to worsening symptoms after reading. Worsening corneal staining results correlated with the baseline conjunctival staining values and surface regularity index.

    The authors advocate use of the OSDI for more precise quantification of dry eye symptoms, particularly in clinical studies involving treatment comparisons. They also suggest that pa­tients’ dry eye symptoms be quantified after a period of silent reading, rather than at rest. (Also see related commen­tary by Saaeha Rauz, PhD, FRCOphth, in the same issue.)

    The original article can be found here.