New dry eye phenomenon arises from wearing masks

Photo by Polina Tankilevitch from Pexels

People are being advised to be aware of the increased chance of dry eye after Canadian researchers named and reported a new phenomenon - mask-associated dry eye or MADE - due to the widespread use of face masks to combat the spread of COVID-19.

Experts from the Centre for Ocular Research & Education (CORE) at the University of Waterloo’s School of Optometry and Vision Science said there had recently been increased reports of dry eye and a recent review from American researchers concluded that eye dryness and irritation from mask wear may become a problem for a large percentage of the population.

Director of CORE, optometrist Professor Lyndon Jones, advised eye care professionals how to recognise mask-associated dry eye and methods to mitigate the condition.

"Face masks are crucial in the fight against COVID-19 and eye care professionals are well-positioned to provide patients with advice on appropriate wear in order to maximise eye comfort," he said. "Asking patients about their mask-wearing experiences and providing a few helpful tips takes little time and can make a substantial difference.

"Masks significantly reduce the outward spread of air. However, exhaled air still needs to disperse and when a mask sits loosely against the face the likely route is upwards. This forces a stream of air over the surface of the eye, creating conditions that accelerate tear film evaporation, leading to dry spots on the ocular surface and discomfort.

"As well as worsening symptoms in patients with pre-existing dry eye disease, MADE can affect the elderly who typically have a poorer quality tear film, contact lens wearers, and masked people working extended hours in air-conditioned settings and/or while using digital screens."

MADE may also encourage people to rub their eyes for temporary relief—raising the possibility of unwashed hands being brought to the face which, in turn, increases the likelihood of coronavirus infection through the mouth, nose, and to a lesser extent, the eye, he said.

Tips for mask wearers

CORE recommends that mask wearers experiencing dry eye symptoms try straight-forward solutions:

  • Ensure that a mask is worn appropriately, particularly with spectacles or sunglasses. A carefully taped top edge that does not interfere with blinking may help.
  • Apply lubricating eye drops, asking their optometrist for recommendations.
  • Limit time in air-conditioned environments and take regular breaks from digital devices.

Professor Jones stressed that people should first check with their optometrist for advice and to rule out other causes of dry eye. He was also adamant that bringing attention to MADE should not be used to support anti-mask wearing sentiments.

"Responsibly wearing a mask, even when having to contend with eye dryness, is a critical part of overcoming the global pandemic," he said. "The good news is that we understand MADE and can address it."

If you feel you are suffering from MADE, please make an appointment with an optometrist to discuss solutions. And read also about how to stop your glasses from fogging when wearing a mask here.

Image source: Centre for Ocular Research and Education, University of Waterloo, Canada

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