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Chronic dry eye can severely affect reading rates in older adults. This according to research conducted by John Hopkins Medicine. Dry eye syndrome is a condition in which natural tears do not adequately moisten the eyes. Tasks that involve visual concentration for prolonged periods of time are most affected by this condition.

Research published in Optometry and Vision Science shows dry eye sufferer’s reading rate decreasing by 10% when compared to the general population. 186 adults took part in this study. People affected by dry eye experience discomfort if they read for 30 minutes or more.

Esen Akpek, M.D., the lead investigator in the study and Ophthalmology Professor at Johns Hopkins, says that chronic dry eye impacts millions in America. Primarily those over 50, causing eye discomfort and vision issues. She states that many of her patients complain they can’t drive at night, see small print or do computer work, despite having perfect vision on standard eye tests. She believes standard 75-word eye exams are insufficient to uncover dry eye issues. This is because visual acuity (sharpness), degrades over a long time and cannot be seen during a standard test.

Akpek says they suspected people with chronic dry eye could not maintain good reading performance over a longer time because their tears cannot lubricate the eye surface at a sufficient rate.

To test this theory, the researchers recruited 186 carefully selected participants from the Wilmer Eye Institute. Participants were over 50 and did not use eyedrops in the day prior to testing. The average age of the participants was 63.2, 116 had chronic dry eye, 39 had symptoms of dry eye but had not been clinically diagnosed, and a control group of 31 participants had no dry eye. Of the group, 131 with chronic dry eye and 23 of the control group were women.

The Ocular Surface Disease Index questionnaire was administered to all participants. This 12-question survey asks patients about symptoms such as visual quality and eye discomfort. There are also questions about environmental issues such as smoke and wind.

Sezen Karakus, M.D., professor of ophthalmology, then administered a 7,200-word reading test that takes half an hour to complete. This test was created by Pradeep Ramulu, M.D., Ph.D., head of the Glaucoma branch of the Wilmer Eye Institute. This test is much longer than the standard reading test and allowed researchers to see the full effects of chronic dry eye.

Those with clinically significant dry eye (116 participants) read at a slower rate than those with dry eye symptoms (39 participants) and the control group (31 participants). Those with clinically verified dry eye read at a rate of 240 words per minute on average, 32 words per minutes lower than the other groups.

The research team also found that continuous visual function such as driving, reading or performing surgery stresses everyone’s eyes. This is because it changes blink rate, which replenishes and distributes tears on the cornea. This change in blink rate affects people with chronic dry eye more severely.

Karakus collected tiny vials of tear from subjects before and after the reading test. She hopes that future research on these samples will offer clues into the mechanisms involved in chronic dry eye and possible treatments.

According to Akpek, diagnosing and treating dry eye is often difficult. This is because many conditions including clogged oil glands and inflammation from rheumatologic disease can cause it.

Akpek believes the best treatments are those designed to address the underlying causes of chronic dry eye, the extent of tear deficiency and the patient’s activities. She says dry eye sufferers should try over the counter eye drops for relief, but also recommends they see a professional for diagnosis and treatment.

Available treatments include prescription grade eyedrops, environmental and lifestyle changes, and surgery to implant plugs and other devices to aid tear production.

Akpek states dry eye is not well understood. People don’t often associate their eye discomfort symptoms such as fluctuating vision or stinging to chronic dry eye. Most people self-treat with over the counter products.

It’s easy to get a dry eye test using a questionnaire similar to the one mentioned above. An optometrist or ophthalmologist is able to identify symptoms and refer the patient.

The researchers hope to find indicators of the disease’s causes in the samples collected. Similar experiments with younger people are also a possibility. This will help to determine how dry eye impacts work productivity and learning.

Dr. Joseph Cohen O.D.
Woodland Hills Optometrist
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