Effects of Face-Mask Use on Dry Eye Disease Evaluated Using Self-Reported Ocular Surface Disease Index Scores: A Cross-Sectional Study on Nurses in Saudi Arabia

Abstract

Background: Wearing face masks has been an essential part of healthcare workers’ lives since the coronavirus disease 2019 (COVID-19) pandemic. This study aims to determine the association between prolonged face mask-wearing and dry eye disorder (DED) among female nurses. Methods: An online questionnaire-based cross-sectional study was conducted at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between May 2021 and February 2022. It covered sociodemographic data, conditions associated with ocular irritation, and questions related to mask-wearing duration. The Ocular Surface Disease Index (OSDI) survey was used to measure DED severity. Binary logistic regression analysis was done and Odd’s ratios (OR) with 95% confidence intervals (CI) were reported. Results: A total of 266 female nurses responded to this study. The majority of the sample (71.1%) fell in the normal-mild DED category (OSDI 0-22), while (28.9%) were categorized as the moderate-severe DED category (OSDI >22). We found a significant independent association of dry eye disorder with wearing a mask for >6 hours/day (OR 2.066, 95% CI: 1.083-3.944). Other significant predictors of DED in this study were wearing corrective eyeglasses (OR 2.382, 95% CI: 1.296-4.376) and having rheumatoid arthritis (OR 17.289, 95% CI: 1.794-166.7). Conclusion: Wearing a face mask for > 6 hours/day was significantly associated with moderate to severe DED among female nursing staff. Ophthalmologists should be aware of this adverse effect in order to promote ways to relieve this condition.

Prolonged Face Mask Wearing Worsens Self-Reported Dry Eye Symptoms during the COVID-19 Pandemic in Dental Healthcare Practitioners

“…In a recent study, Motwani et al ( 27 ) found that wearing a face mask for more than three to six hours per day could exacerbate or increase the symptoms of DED among healthcare professionals who had previously had the condition and were under the age of 40. According to research by Alsulami et al ( 31 ) among female nursing staff, wearing a mask for more than six hours per day was substantially related to moderate to severe DED. In addition, Shalaby et al ( 25 ) study discovered a substantial positive link between the OSDI, corneal staining, and the amount of hours per day spent wearing a face mask, as well as a strong negative correlation with the Schirmer test.…”

“…In addition, Shalaby et al ( 25 ) study discovered a substantial positive link between the OSDI, corneal staining, and the amount of hours per day spent wearing a face mask, as well as a strong negative correlation with the Schirmer test. According to Alsulami et al ( 31 ) among female nursing personnel, wearing a face mask for more than six hours per day was substantially related with moderate to severe DED. Boccardo documented that in the general population, retailers were a possible risk factor for MADE; they reported more MADE compared to the other professionals.…”

Important Repercussions of the COVID-19 Pandemic Lifestyle Avoided by Researchers? Face Masks and Temporomandibular Disorders: A Systematic Search and Review

“…One of the biggest causes of discomfort are also breathing problems [42,[50][51][52][53], especially in people suffering from asthma [53]. The prolonged face mask use can also affect ocular health by exacerbating dry eye symptoms [54,55,56], [57] or creating visual artifacts due to improper fit [58], which, as one of the existing cases showed, also plays a role in worsening those symptoms by directing the exhaled air into the user's eyes [59]. Worth noting is that one of the studies discussed in this paper regarding the influence of mask use on TMJ disorders, also showed that the improper fit of a face mask can impair this joint's health due to repetitive movements [35], which could be induced by discomfort coming from blowing exhaled air into the eyes.…”