MASK-ASSOCIATED DRY EYE DISEASE: A NEW GLOBAL REALITY

Published 2023 - 27th ESCRS Winter Meeting

Reference: O55 | Type: Free Paper Submission | DOI: 10.82333/bpg0-9156

Authors: Ana Faria Pereira* ¹ , Mário Lima-Fontes ¹ , Rita Teixeira Martins ¹ , João Tavares Ferreira ¹ , Fernando Falcão-Reis ¹ , João Pinheiro-Costa ¹

¹Centro Hospitalar e Universitário de São João,Porto,Portugal

Purpose

The purpose of this work was to assess the change in dry eye symptoms in healthcare professionals 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.

Setting

The Covid-19 pandemic introduced profound changes in our daily habits, including the frequent use of face masks. Numerous reports from around the world pointed to an increase in perceived dry eye symptoms, due to an unnatural airflow towards the ocular surface during expiration.

Methods

Ocular Surface Disease Index (OSDI) questionnaire was used to assess symptoms of dry eye disease. In each answer, the participants were asked to self-report the symptoms at two different time points: before the generalized use of face masks (before Covid-19 pandemic) and at present. In addition, all volunteers underwent a noninvasive 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

40 eyes from 20 subjects were included. 80% (n=16) of the participants 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 observed 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

In this work, 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 surface health risks related to face masks, and fitting strategies should be adopted to try to minimize the discomfort associated with this condition.