Investigating Mask-Associated Dry Eye and Contributing Factors in Healthcare Providers

Kathryn S Park, Bryanna J Lee, Michael J Ang, Medi Eslani, Sarah Shacterman, Jonghwa Jun, Maria L Gomez, Don O Kikkawa, Natalie A Afshari Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, San Diego, CA, 92037, USACorrespondence: Natalie A Afshari, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, 9415 Campus Point Drive, La Jolla, CA, 92037, USA, Tel +1 858 534 6290, Email [email protected]: To evaluate mask-associated dry eye among healthcare providers and assess the impact of glasses, contact lenses, and mask types on ocular surface parameters.Patients and Methods: This prospective study included 50 healthcare providers who wore face masks throughout the day and 10 control subjects who did not. Ocular surface assessments were conducted in the morning and after a full workday. Assessments included the Ocular Surface Disease Index (OSDI), tear osmolarity, tear breakup time (TBUT), ocular staining score, Schirmer I test, and LipiView™ interferometer parameters: lipid layer thickness (LLT), Meibomian gland dropout (MGd), incomplete/complete blinks, and partial blinking rate (PBR).Results: Fifty healthcare providers (mean age 39.83 ± 12.3 years) and 10 controls (mean age 29.40 ± 14.43 years) were included. Mask use averaged 7.15 ± 1.15 hours daily. Mask use was associated with a significant increase in OSDI scores compared to controls (mean change 4.50 ± 10.17 vs − 1.00 ± 1.94; P = 0.041) and a larger decrease in TBUT in the right eye (mean change − 1.65 ± 3.37 vs 0.30 ± 1.57; P = 0.008) and left eye (mean change − 1.40 ± 2.91 vs − 1.20 ± 1.93; P = 0.046). No significant changes were observed in tear osmolarity, LLT, MGd, or Schirmer I results. Glasses were correlated with a smaller decrease in TBUT in the right eye (r2 = 0.085, P = 0.044) and left eye (r2 = 0.125, P = 0.013).Conclusion: Mask use is associated with increased OSDI scores and decreased TBUT, potentially worsening dry eye disease. Glasses may offer some protection, but further research is needed to fully address mask-associated dry eye.Keywords: dry eye, tear break-up time, tear film