A new study establishes that contact lens wear offers an option for a better vision correction experience than spectacles when paired with face masks, and doing so likely improves adherence to mask use. Conducted by Eurolens Research at the University of Manchester, it is the first work to compare the use of any type of face mask with the two types of vision correction.
The study’s corresponding paper—Using face masks with spectacles versus contact lenses (Maldonado-Codina C, et al.) is now in press with Contact Lens and Anterior Eye, the peer reviewed journal of the British Contact Lens Association. It can be downloaded at no charge via Open Access.
“Since mask wear became widespread in early 2020, anecdotal reports of problems with fogging when wearing spectacles have been common. Our work agreed with these reports and revealed additional aspects of mask wear and visual correction that favor contact lens prescribing,” said Carole Maldonado-Codina, BSc(Hons), MSc, PhD, MCOptom, FAAO, FBCLA, Senior Lecturer in Optometry at the University of Manchester and the paper’s lead author.
Thirty study participants—all habitual spectacles wearers with no history of contact lens use—were randomized to continue in spectacles (n=15) or wear somofilcon A daily disposable contact lenses (n=15). A surgical face mask (Type II R) was worn for at least one hour per day on four or more days per week. After two weeks, participants completed the Quality of Life Impact of Refractive Correction (QIRC) questionnaire and a two-part face mask usability questionnaire, as well as assessing their ocular-related symptoms with visual analog grading scales (VAS).
Individual QIRC responses showed statistically significant differences for enjoying outdoor activities, participating in fitness activities, and being able “to do the things you want to do.” Better scores were observed for the contact lens group.
For face mask usability, the study showed statistically significant differences again favoring contact lens wear for breathability, heat, comfort on ear lobes, and overall comfort. The paper’s authors offer perspectives on changed behaviors and perceptions while combining masks and spectacles, such as disrupting normal breathing patterns to avoid fogging and having a ‘heat’ sensation from humid exhalation lingering behind spectacle lenses.
The second part of the face mask questionnaire similarly showed higher subjective ratings for contact lenses across multiple dimensions, including walking, driving, reading, computer use, exercising, and socializing.
Subjective VAS scores for ocular-related symptoms at participant follow-up visits indicated significantly greater scores for the somofilcon A daily disposable contact lenses compared with the spectacle group for distance vision, near vision, glare, fogging, restricted field of view, and peripheral blur.
No differences were observed between groups for dryness, comfort, or redness. This suggests that mask-associated dry eye (MADE)-related symptoms are similar when somofilcon A daily disposable contact lenses or spectacles are used with face masks, i.e., there is no obvious ‘protective’ effect from using spectacles.
A short message service (SMS) text was sent to the mobile phone of each participant every other evening to capture a score for overall performance of their vision correction at the time of receipt. Responses showed a statistically significant difference in favor of the contact lenses.
The authors note that difficulties with face masks are a deterrent to correct use and could even cause mask abandonment, which may lead to lower levels of protection from COVID-19 and other viruses. This is particularly relevant to healthcare workers who face long periods of correct mask use to comply with clinical infection control standards.
In their conclusion, the authors offer a clear recommendation, writing “the findings of this work suggest that where possible, contact lenses should be the preferred vision correction option for people using face masks.”
“Eye care professionals should consider discussing these findings with all of their patients, even those who have never tried contact lenses before. Even if patients love their spectacles, there is an opportunity for dual wear, swapping their frames for contact lenses when they’ll be wearing a mask. It could be a relatively straightforward approach with positive implications for multiple aspects of a person’s daily life,” said Dr. Maldonado-Codina.