Impact of Glaucoma and Dry Eye on Text-Based Searching

We determine if visual field loss from glaucoma and/or measures of dry eye severity are associated with difficulty searching, as judged by slower search times on a text-based search task.

Glaucoma patients with bilateral visual field (VF) loss, patients with clinically significant dry eye, and normally-sighted controls were enrolled from the Wilmer Eye Institute clinics. Subjects searched three Yellow Pages excerpts for a specific phone number, and search time was recorded.

A total of 50 glaucoma subjects, 40 dry eye subjects, and 45 controls completed study procedures. On average, glaucoma patients exhibited 57% longer search times compared to controls (95% confidence interval [CI], 26%-96%, P < 0.001), and longer search times were noted among subjects with greater VF loss (P < 0.001), worse contrast sensitivity (P < 0.001), and worse visual acuity (P = 0.026). Dry eye subjects demonstrated similar search times compared to controls, though worse Ocular Surface Disease Index (OSDI) vision-related subscores were associated with longer search times (P < 0.01). Search times showed no association with OSDI symptom subscores (P = 0.20) or objective measures of dry eye (P > 0.08 for Schirmer's testing without anesthesia, corneal fluorescein staining, and tear film breakup time).

Text-based visual search is slower for glaucoma patients with greater levels of VF loss and dry eye patients with greater self-reported visual difficulty, and these difficulties may contribute to decreased quality of life in these groups.

Visual search is impaired in glaucoma and dry eye groups compared to controls, highlighting the need for compensatory strategies and tools to assist individuals in overcoming their deficiencies.