Impact of Glaucoma and Dry Eye on Text-Based Searching.

Purpose: 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.

Methods: 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.

Results: 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%, < 0.001), and longer search times were noted among subjects with greater VF loss ( < 0.001), worse contrast sensitivity ( < 0.001), and worse visual acuity ( = 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 ( < 0.01). Search times showed no association with OSDI symptom subscores ( = 0.20) or objective measures of dry eye ( > 0.08 for Schirmer's testing without anesthesia, corneal fluorescein staining, and tear film breakup time).

Conclusions: 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.

Translational Relevance: 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.