Mathews Priya M, Ramulu Pradeep Y, Swenor Bonnielin S, Utine Canan A, Rubin Gary S, Akpek Esen K
The Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland, USA.
Department of Ophthalmology, Dokuz Eylul University, Izmir, Turkey.
Br J Ophthalmol. 2017 Apr;101(4):481-486. doi: 10.1136/bjophthalmol-2015-308237. Epub 2016 Jul 22.
BACKGROUND/AIMS: 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.
背景/目的：评估干眼对阅读能力的影响。
使用标准化文本评估具有临床显著意义的干眼患者（n = 41）和对照组（n = 50）的大声朗读和默读情况。干眼测量指标包括泪膜破裂时间、泪液分泌试验和角膜上皮染色。通过眼表疾病指数（OSDI）评估症状。
与对照组相比，干眼组女性比例更高，但在年龄、种族、教育水平或视力方面无差异（所有p≥0.05）。干眼受试者大声朗读速度平均为每分钟148个单词（wpm），对照组为163 wpm（p = 0.006）。干眼受试者长时间默读速度平均为199 wpm，对照组为226 wpm（p = 0.03）。在多变量回归模型中，与对照组相比，干眼受试者大声朗读和持续默读速度分别慢10 wpm（95% CI -20至-1 wpm，p = 0.039）和14%（95% CI -25%至-2%），p = 0.032）。角膜染色程度越高，大声朗读（染色评分每增加1单位，-2 wpm，95% CI = -3至-0.3 wpm）和默读速度（-2%，95% CI -4至-0.6 wpm）越慢（两者p<0.02）。在大声朗读速度方面，发现OSDI评分与单词特定特征（更长和使用频率更低的单词）之间存在显著交互作用（两者p<0.05）。
干眼与较慢的大声朗读和默读速度相关，为干眼的功能影响提供了直接证据。阅读速度是一项可测量的临床发现，与干眼严重程度直接相关。
