Mask-Associated Dry Eye Disease: A New Global Reality

• Autor(a) principal: Lima-Fontes, Mário
• Data de Publicação: 2023
• Outros Autores: Faria Pereira, Ana, Teixeira Martins, Rita, Tavares Ferreira, João, Falcão Reis, Fernando, Pinheiro Costa, João
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.48560/rspo.28270
• topic: Artigos Originais

INTRODUCTION: The COVID-19 pandemic introduced significant changes in our daily habits, including the widespread use of face masks. Numerous reports pointed to an increase in perceived dry eye symptoms, due to an unnatural airflow towards the ocular surface during expiration. The purpose of this work was to assess the change in dry eye symptoms in healthcare profes- sionals with the frequent use of face masks and to measure the effect of a half-workday period of mask wearing in noninvasive ocular surface parameters. METHODS: Ocular Surface Disease Index (OSDI) questionnaire was used to assess symp- toms of dry eye disease. In each answer, the participants were asked to self-report the symptoms before and after the generalized use of face masks. In addition, all volunteers underwent a nonin- vasive ocular surface workup by means of TearCheck® (ESW Vision, Linz, Austria) in the same day at 2 different time points: 1 - in the beginning of the work shift before wearing face mask; 2 - after 6 hours of continuous face mask use. Eye redness score (range 1-4), non-invasive break-up time (NIBUT), tear meniscus thickness and tear film stability evaluation (TFSE®) variation between the two measurements was calculated. RESULTS: Forty eyes from 20 subjects were included. A percentage of 80% (n=16) of the par- ticipants were female and the mean age of the sample was 47.15 ± 12.99 years old. A mean increase in the OSDI score of 15.33 ± 10.80 points was noted when comparing the pre- and the COVID-19 periods (p<0.001***). Concerning the ocular surface parameters, the following evolution was ob- served after 6 hours of face mask use: eye redness score increased 0.75 ± 0.74 points (p<0.001***); tear meniscus thickness decreased 0.04 ± 0.13 mm (p=0.034*); and NIBUT reduced 2.20 ± 3.82 s (p=0.007**). A non-significant increase in TFSE® of 45.11 ± 212.26 points was also noticed (p=0.211). CONCLUSION: We report a clear increase in dry eye symptoms and signs associated with the use of face masks. Ophthalmologists should advise their patients of the potential ocular sur- face health risks related to face masks, and fitting strategies should be adopted to minimize the discomfort associated with this condition.