Mask Associated Dry Eye (MADE) in Healthcare Workers: A Cross-sectional Study

Abstract

Introduction: The Coronavirus disease-19 (COVID-19) pandemic mediated by Severe Acute Respiratory Syndrome-CoV2 (SARS-CoV2), made the use of face masks mandatory to check the spread of the disease. With the increased use of face masks, more people started presenting to the ophthalmologist with symptoms of dry eye. The proposed mechanism of dry eye was attributed to air blowing upwards from behind the mask into the eyes, especially in loose fitting masks. This air leads to rapid evaporation of tears and disturbance of homeostasis of the tear film. Aim: To measure self reported symptoms of dry eye and to establish mask use as a risk factor for the development of Dry Eye Disease (DED) in healthcare workers in a Tertiary Care Hospital. Materials and Methods: This cross-sectional, observational study was conducted at Nilratan Sircar (NRS) Medical College and Hospital for a duration of three months from December 2021 to February 2022. The study was conducted on 146 participants. An online survey was conducted using Google Forms, sent via email to hospital employees working in different departments of the hospital. All healthcare workers employed at NRS Medical College and Hospital who wore a face mask during duty hours and were willing to participate in the study were included. The Ocular Surface Disease Index (OSDI) questionnaire was used and modified by adding “while wearing a facemask” to the end of each question. To establish face mask use as a causative agent for development of DED, a few other questions related to face mask usage were included in the survey. The data was tabulated in Microsoft Excel and analysed with Statistical Package for Social Sciences (SPSS) version 24. Results: The mean age of the study population was 27.4±8.28 years. The mean hours of wearing a mask was 6.38 ±3.04 hours. N95 face mask was the most common type of mask used. The study population included 100 doctors, 14 nursing staff, 18 optometrists, eight group D staff (sweepers and ward attendants), and six dieticians. The mean OSDI score was 14.24. Increased usage of face masks, in particular surgical, more hours of reading significantly correlated with higher incidence of DED. Conclusion: This study showed that increased hours of face mask use in particular surgical was associated with development of DED. To encourage more people to wear face masks, all possible problems arising from face mask use should be promptly identified and dealt with.

Keywords

• coronavirus disease-19
• dry eye disease
• ocular surface disease index