While mask wear does cause ocular surface symptoms, it’s still recommended to protect against infection. Photo: Getty Images.

Patients may complain about dry eye symptoms associated with mask wear, especially at the peak of the pandemic. A recent study confirmed that mask wear does have some effect on the ocular surface; however, it doesn’t outweigh the benefits of protection against the spread of airborne pathogens.

The researchers recruited 54 subjects (74% male, aged 18 to 40) to complete a standardized patient evaluation for eye dryness. Patients also underwent noninvasive tear breakup time (TBUT), phenol red thread and tear ferning tests, with five minutes between each test. The subjects then wore surgical face masks for one hour and were tested again immediately after removal.

The researchers reported significant differences in the Wilcoxon test between standardized patient evaluation of eye dryness and TBUT scores before and after mask wear. They didn’t note any significant differences between the phenol red thread scores or tear ferning grades before or after mask wear. They did note strong correlations among standardized patient evaluation of eye dryness score, TBUT and tear ferning grades before and after mask wear, as well as medium correlations between TBUT scores and tear ferning grades before and after mask wear.

“Wearing a surgical face mask for a short duration of one hour has an effect on the ocular tear film in normal eye subjects,” the researchers concluded in their paper. “Dry eye symptoms and TBUT increased after wearing a face mask compared with those experienced before wearing one. However, the difference between the scores collected from the phenol red thread and tear ferning tests, before and after wearing a face mask, was not significant.”

The researchers emphasized, “Although wearing a face mask has an effect on the ocular tear film, it remains an effective way to reduce the spread of COVID-19.” They recommended that eyecare providers “provide help and advice to reduce or treat symptoms associated with dry eye.”

Alanazi MA, El-Hiti GA, Al-Tamimi R, et al. Assessment of the effect of wearing a surgical face mask on tear film in normal eye subjects. Hindawi J Ophthalmol. 2022;2484997:1-6.