Influence of Personal Respiratory and Visual Protective Equipment on the Development and Progression of Dry Eye Syndrome

Abstract

Purpose. To study the influence of personal protective equipment (PPE) of the respiratory and visual systems on the development and progression of dry eye syndrome (DES) and its relationship with other risk factors for medical workers.Patients and methods. The data of 243 people (male — 22.2 %, female — 77.8 %) were analyzed as part of a multi-center analytical scientific one-step study. Total tear production (Schirmer I test) was studied at the beginning and the end of the working day in persons used PPE of respiratory system (disposable medical face mask, gauze masks or different types of respirators), as well as PPE of the eyes (protective half-closed/closed glasses or protective screens). Risk factors for the development and progression of DES were registered (age, smoking, systemic hormones intake, soft contact lenses), as well as the use of artificial tears.Results. A decrease in the Schirmer I test score at the end of a 7–8 hour work shift was found by an average of 3 mm (from 13 (9; 16) mm to 10 (6; 15) mm, p < 0.001). Statistically significant changes were typical mainly for medical personnel (p < 0.001) with the maximum severity in persons working in outpatient sector. The presence of at least one DES risk factor was found in 30.5 % of patients, two factors — in 3.0 %, and three or more — in 7.0 %. There was no influence of risk factors on the degree of changes in total tear production. Reduced tear production is typical for some PPE of respiratory system (disposable masks and respirators) and the eye (screens and half-closed glasses) (p < 0.001). In people who do not use PPE of the eye, significant changes were detected only in the presence of risk factors.Conclusion. The negative influence of various PPE of the respiratory system and eye on the total tear production was established. The decrease in the results of the Schirmer I test by the end of the working day was 20–25 % of the basic level, regardless of the presence of traditional risk factors for DES. The severity of changes depended on the type of PPE used. The data obtained are particularly relevant during the new COVID-19 coronavirus pandemic and justify the need to establish specific prophylactic measures. One of the possible methods is the preventive use of artificial tears.

Potential combined ocular effects of mask wear and digital device usage during COVID-19 pandemic

“…Among respiratory protective gear such as half-closed or closed glasses, protective screens, disposable face masks, or respirators, users have significantly impacted tear production during the pandemic period. Mask wear for 8 hours has reduced the Schirmer's values by 3mm [29]. In a study, the type of mask wear and duration of mask wear also showed similar results.…”

Does Continuous Wear of a Face Mask Affect Your Tear Film?

“…Reduced tear quantity after wearing respiratory PPE, including facemasks and respirators, is also seen. Schirmer's values reduced by 3mm after 8 hours of PPE usage [18].…”

Pathogenetic Mechanisms Of Dry Eye Syndrome In A Novel Coronavirus Infection Caused By SARS-CoV-2

“…Improper and prolonged wearing of masks/respirators causes an uneven distribution of exhaled warm air and increase in the evaporation of tear fluid from the ocular surface [66]. This mechanism of DES development is similar to the mechanism underlying constant positive airway pressure (CPAP) therapy, which results in augmented tear evaporation, eye irritation, and squamous metaplasia of the conjunctiva [67].…”