To measure the impact of reader of reader visual fatigue by assessing symptoms, the ability to keep the eye focused on the display and diagnostic accuracy. Twenty radiology residents and 20 radiologists were given a diagnostic performance test containing 60 skeletal radiographic studies, half with fractures, before and after a day of clinical reading. Diagnostic accuracy was measured using area under the proper binormal curve (AUC). Error in visual accommodation was measured before and after each test session and subjects completed the Swedish Occupational Fatigue Inventory (SOFI) and the oculomotor strain subscale of the Simulator Sickness Questionnaire (SSQ) before each session. Average AUC was 0.89 for before work test and 0.85 for the after work test, (F(1,36) = 4.15, p = 0.049 < 0.05). There was significantly greater error in accommodation after the clinical workday (F(1,14829) = 7.81, p = 0.005 < 0.01), and after the reading test (F(1,14829) = 839.33, p < 0.0001). SOFI measures of lack of energy, physical discomfort and sleepiness were higher after a day of clinical reading (p < 0.05). The SSQ measure of oculomotor symptoms (i.e., difficulty focusing, blurred vision) was significantly higher after a day of clinical reading (F(1,75) = 20.38, p < 0.0001). Radiologists are visually fatigued by their clinical reading workday. This reduces their ability to focus on diagnostic images and to accurately interpret them.