A recent paper published in Cureus on mask-associated dry eye (MADE) in healthcare workers found further evidence to support that extended face mask usage contributes to the worsening of dry eye disease (DED) symptoms.
Tell me about the study.
Researchers at the All India Institute of Medical Sciences in Hyderabad conducted an observational cross-sectional study of 114 healthcare workers who used face masks regularly. The patients were given a modified Ocular Surface Disease Index (OSDI) questionnaire that included questions about daily mask wear including duration and type, as well as the symptoms, severity, and history of DED.
Patients were then divided into groups based on gender, age ( >40 and age 40 to 60), face mask wear duration (<3 hours, 3-6 hours, and >6 hours), and DED history. Ophthalmological examinations were performed, which included Schirmer tests, tear break-up time (TBUT), staining, and slit lamp assessment of the anterior segment.
What did they find?
The study found a significantly higher OSDI score in the group of healthcare workers who wore masks for over six hours compared to the other two groups. Men had a higher OSDI score than women, as did the group of participants under 40. Additionally, the group of patients who preferred N95 masks had the highest OSDI score.
What does this mean?
One popular theory behind MADE is that air is channeled out of the mask and upwards into the eyes, increasing the rate of tear evaporation and drying the ocular surface. This theory would support a higher OSDI score among surgical mask wearers rather than those wearing N95, however. The authors suggest further research is needed to isolate the etiology of MADE.
The take home.
Medical professionals must protect themselves and their patients through the use of personal protective equipment (PPE); face masks play a major part in this. Healthcare professionals in every field are also patients themselves, and should be aware of the potential for worsening symptoms of DED and the steps they can take to alleviate them.
The authors concluded: “Ophthalmologists should inform their patients about the potential risks that improperly fitted facemasks may pose to the health of their ocular surface. It takes little time and can make a big difference to ask patients about their experiences wearing masks and give a few helpful tips.”