By Denis Langlois

The widespread use of face masks during the global COVID-19 pandemic has led to a notable rise in reports of dry, uncomfortable eyes, according to the Centre for Ocular Research & Education at the University of Waterloo.

As a result, the organization is advising eye care professionals on how to recognize mask-associated dry eye and is encouraging ECPs to provide advice to their patients on how to alleviate symptoms, such as by using lubricating eye drops.

CORE clinical scientist Karen Walsh said the increase in mask-associated dry eye is a concern.

“Patients who experience uncomfortable eyes when wearing their mask may be more likely to touch their face or rub their eyes or perhaps end up discouraged from wearing a mask at all,” she says.

“Eye care professionals are extremely well-placed to be able to identify the presence of mask-related dryness issues and can help patients to improve their eye comfort through a number of simple steps. This should enable people to be able to continue wearing masks when necessary, maintaining the comfort of their eyes throughout.”

A new CORE-developed infographic includes information on the causes of mask-associated dry eye and solutions.

They include using lubricating eye drops, which can help alleviate dry-feeling eyes. Patients should consult with their ECPs on their recommendations, the infographic says.

CORE says reports of mask-associated dry eye have been circulating since early summer, but a recent review has concluded that eye dryness and irritation from mask wear may become a problem for a large percentage of the population.

While health experts say face masks help to prevent the spread of the novel coronavirus, they also significantly reduce the outward spread of exhaled air. When masks sit loosely against the face, it forces a stream of air over the surface of the eye, according to CORE, which, in turn, creates conditions that accelerate tear film evaporation. That leads to dry spots on the ocular surface and discomfort.

Mask-associated dry eye can worsen symptoms in patients with pre-existing dry eye disease and also affect the elderly who typically have poorer quality tear film as well as contact lens wearers and people who wear a mask while working extended hours in air-conditioned settings or while using digital screens.

Walsh says ECPs should be proactive in asking how their patients’ eyes feel when they wear a mask and provide tips for alleviating symptoms of mask-associated dry eye, such as wearing a close-fitting mask, using lubricating drops and taking regular breaks from situations that can contribute to dry-feeling eyes, such as air conditioned environments and long periods of digital device use.

She says paying attention to wearing a well-fitting mask that limits the upward movement of air is the first step towards preventing mask-associated dry eye.

Dr. Lyndon Jones, director of CORE, is adamant, however, that bringing more attention to mask-associated dry eye 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. The good news is that we understand MADE and can address it—an opportunity for ECPs to further communicate their knowledge and ongoing value to patients at a time when sound, scientific guidance is needed more than ever,” he says.