Effect of long-term use of protective masks on dry eye syndrome during the COVID-19 pandemic

Background People have been using face masks for long periods of time during the COVID-19 pandemic. Research shows that wearing them for long periods of time may worsen the symptoms of patients with dry eye syndrome (DES). One study analyzed hospital workers aged 18 years and older with DES who wore face masks at least 80% of the time during long shifts of 6 hours or longer. Two methods were used: the Dry Eye Questionnaire-5 (DEQ-5) and the Ocular Surface Disease Index (OSDI) [1–3]. The first study found that 90% of participants reported worsening DES symptoms at work due to masks, despite increased moisture around the eyes. Participants using loose-fitting masks (especially those without a flexible nose strip) were more likely to experience increased symptoms of dryness, burning, gritty eyes, irritation, itching, foreign body sensation, and blurred vision. Another study analyzed 31 patients with moderate to severe dry eye syndrome. Tear breakup time was measured noninvasively (without fluorescein staining) using the Oculus Keratograph 5M (Oculus, Wetzlar, Germany). Two measurements were taken: during the first measurement, the patient continued to wear the medical mask with which he came to the appointment, and the second measurement was taken 10 min after removing the mask. It was found that with a medical mask on the face, the first nTBUT was on average 6.2 ± 3.8 s (range 2–19.8); 10 min after removing the mask, the first nTBUT increased to an average of 7.8 ± 5.6 s (range 2.3–24) (p = 0.029), a difference of -1.6 ± 0.7 s (CI 95% from -3.1075 to -0.1770). The mean nTBUT with a medical mask on the face was 12.3 ± 4.8 s (range 4–19.4); 10 min after removing the mask, the mean nTBUT increased to 13.8 ± 5 s (range 5.5–24) (p = 0.006), a difference of -1.5 ± 0.5 s (CI 95% from -2.5290 to -0.4458) [4, 5]. Conclusion Long-term wearing of protective masks during the COVID-19 pandemic affected the course of dry eye syndrome, worsening its symptoms. Keywords: face masks; dry eye syndrome