|
|
LETTER TO THE EDITOR |
|
Year : 2021 | Volume
: 69
| Issue : 2 | Page : 448-449 |
|
Mask-associated dry eye disease and dry eye due to prolonged screen time: Are we heading towards a new dry eye epidemic during the COVID-19 era?
Suresh K Pandey, Vidushi Sharma
SuVi Eye Institute & Lasik Laser Center, Kota, Rajasthan, India
Date of Web Publication | 29-Dec-2020 |
Correspondence Address: Dr. Suresh K Pandey C 13 Talwandi, Kota, Rajasthan - 324 005 India
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/ijo.IJO_3250_20
How to cite this article: Pandey SK, Sharma V. Mask-associated dry eye disease and dry eye due to prolonged screen time: Are we heading towards a new dry eye epidemic during the COVID-19 era?. Indian J Ophthalmol 2021;69:448-9 |
Dear Editor,
The entire world is currently struggling with coronavirus disease-2019 (COVID-19) pandemic and safety measures such as widespread use of face masks, respiratory hygiene, hand hygiene, physical distancing, and throat hygiene have been determined essential to combat COVID-19's spread. To avoid social gatherings and crowded workplaces, most of the work and meetings are done using digital devices on virtual platforms resulting in a considerable increase in screen time. Measures such as the use of face masks by the public remain the single most important aspect to limit the COVID-19 pandemic in the community. However, the ophthalmologists, as well as the general population, need to be aware that the facial mask together with prolonged use of digital devices is giving rise to increased reports of dry eyes in a large number of patients. Scientists from the Centre for Ocular Research & Education (CORE), Waterloo, Canada termed dry eye after use of face mask as mask-associated dry eye (MADE).[1],[2],[3]
Face masks, face shields are crucial in the fight against COVID-19, and most of the ophthalmologists are seeing more and more patients with dry eye as a result of prolong use of face mask and increase in screen time during the COVID-19 pandemic era. The use of face masks significantly reduces the outward spread of air. However, exhaled air still needs to disperse; when a face mask sits loosely against the face (nose and cheek), the likely route of the exhaled air is upwards. This forces a stream of air over the surface of the cornea, creating conditions that accelerate corneal tear film evaporation, leading to dry spots on the ocular surface, ocular irritation, and discomfort.
MADE can also cause worsening of symptoms in patients with pre-existing dry eye disease, post-menopausal dry eye, people using a smartphone or digital devices or computer for more than 2 h. MADE may aggravate dry eye symptoms in the elderly males or post-menopausal females, post-cataract IOL surgery cases, post-Lasik cases, contact lens wearers, who typically have a poorer quality corneal tear film, and masked people working extended hours in air-conditioned settings and/or while using digital screens.
Beyond discomfort, MADE patients may rub their eyes or clean their spectacle for temporary relief—raising the possibility of unwashed hands being brought to the face. In turn, this increases the likelihood of novel coronavirus infection through the mouth, nose, and to a lesser extent, the eye. This can also increase the possibility of allergic conjunctivitis secondary to contents of sanitizers via frequent hand-eye contact.
The ophthalmologists should be aware of this new entity of MADE and educate patients to wear the masks properly, such that exhaled air is not forced over the eyes, while also taking care to continue to encourage the widespread use of masks. Provide advice on alleviating the symptoms, including using info-graphic to help show how a few simple steps can likely provide relief and minimize re-occurrence [Figure 1]. The ophthalmologist must ensure that a face mask is worn appropriately, particularly with spectacles or sunglasses. A carefully taped top edge on the nose (that does not interfere with blinking) may be helpful to minimize the symptoms. Frequent use of lubricating eye drops (as per recommendations by an ophthalmologist) can be helpful to minimize MADE. It is important to limit time in air-conditioned environments, take regular breaks from digital devices by following the 20:20:20 rule to minimize the digital eye strain.
As an effort for overcoming the global COVID-19 pandemic, it is everyone's responsibility to wear a mask when going out at public places, even when having to contend with eye dryness. MADE should not be used as an excuse for not using the mask. However, the ophthalmologists as well as the public need to remain aware of the MADE. The ophthalmologists should further communicate their knowledge about this entity to all their patients during this time of COVID-19 Pandemic when sound, scientific guidance is needed more than ever to win the battle against this invisible enemy.
Future studies will reveal the incidence as well as the magnitude of the problem of the MADE. The use of masks, combined with prolonged screen time due to the easy availability of smartphone and cheap data plans in India, maybe a contributing factor to an epidemic of dry eye diseases in near future. Over 50 crore Indians are now using smart-phones, a 15% increase from 2018. Factors like availability of good-quality affordable smart-phones, expansion of online as well as offline channels, expansion of 4G/LTE networks by the operators are among the key reasons driving the smartphone user growth and most of these users are spending at least 6–8 h on phone each day. A study during the pre-COVID-19 era on dry-eye disease conducted by researchers from Hyderabad, on 1.45 million patients was recently published.[4] The study estimated that based on current incidence rates, 45% or nearly half of India's urban population is likely to be affected by this condition by the year 2030, roughly translating to a staggering 275 million people. Even rural India is likely to see 17 million new patients of the dry-eye disease every year. This would make dry-eye disease a serious health concern, even more common than diseases like diabetes or heart disease. Ophthalmologists, optometrists, vision scientists, health-care workers- let us all join hands together to educate the public and do our best to overcome the forthcoming epidemic of dry eye disease.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
References | | |
1. | Moshirfar M, West WB, Marx DP. Face mask-associated ocular irritation and dryness. Ophthalmol Ther 2020;9:397-400. |
2. | |
3. | |
4. | Donthineni PR, Kammari P, Shanbhag SS, Singh V, Das VA, Basu S. Incidence, demographics, types and risk factors of dry eye disease in India: Electronic medical records driven big data analytics report I. Ocul Surf 2019;17:250-6. |
[Figure 1]
This article has been cited by | 1 |
Ocular surface changes during COVID-19 pandemic among university faculty members with dry eye disease in northern India: A longitudinal study |
|
| Anuprakshi Malik, Sumit Grover, Souvik Manna | | Clinical Epidemiology and Global Health. 2024; 27: 101595 | | [Pubmed] | [DOI] | | 2 |
Efficacy and Safety of Artificial Tears Containing Lipidure and Hypromellose for the Treatment of Moderate Dry Eye Disease in Contact Lens Wearers |
|
| Caterina Gagliano, Marco Zeppieri, Antonio Longo, Giovanni Rubegni, Roberta Amato, Roberta Foti, Francesco Cappellani, Massimiliano Cocuzza, Federico Visalli, Ludovica Cannizzaro, Alessandro Avitabile, Giuseppe Gagliano, Lucia Lapenna, Fabiana D’Esposito | | Medicina. 2024; 60(2): 287 | | [Pubmed] | [DOI] | | 3 |
Dry eye disease: A review of anti-inflammatory therapies |
|
| Annie Nguyen, Ajay Kolluru, Talia Beglarian | | Taiwan Journal of Ophthalmology. 2023; 0(0): 0 | | [Pubmed] | [DOI] | | 4 |
Mask-Associated Dry Eye (MADE) in healthcare professionals working at COVID-19 pandemic clinics |
|
| E Celik, E Polat, EK Gunder, E Barut, T Gonen | | Nigerian Journal of Clinical Practice. 2023; 26(3): 319 | | [Pubmed] | [DOI] | | 5 |
Complex electrocerebral therapy in medical rehabilitation of patients with dry eye syndrome associated with the novel coronavirus infection |
|
| Z. A. Taimazova, A. A. Fedorov, R. M. Gusov, M. ?. Tsiryulik, V. A. Garamyan, A. S. Bochkarev | | Fizioterapevt (Physiotherapist). 2023; (2): 48 | | [Pubmed] | [DOI] | | 6 |
Evaluation of ocular surface disease due to digital usage during COVID-19 pandemic: A cross-sectional study |
|
| Seema Channabasappa, SheetalVishwanath Girimallanavar, Balasubramanyam Aluri, AiswaryaAnn Jose, GreeshmaKrishna Reddy | | Journal of Clinical Ophthalmology and Research. 2023; 11(2): 109 | | [Pubmed] | [DOI] | | 7 |
The Effect of Mask Use on the Ocular Surface During the COVID-19 Pandemic |
|
| Özlem Dikmetas, Hilal Toprak Tellioglu, Izlem Özturan, Sibel Kocabeyoglu, Ali Bülent Çankaya, Murat Irkeç | | Turkish Journal of Ophthalmology. 2023; 53(2): 74 | | [Pubmed] | [DOI] | | 8 |
Considerations of COVID-19 in Ophthalmology |
|
| Maria Letizia Salvetat, Mutali Musa, Francesco Pellegrini, Carlo Salati, Leopoldo Spadea, Marco Zeppieri | | Microorganisms. 2023; 11(9): 2220 | | [Pubmed] | [DOI] | | 9 |
Impact of COVID-19 on the Prevalence of Dry Eye Among Young Adults in Kuala Lumpur Malaysia |
|
| Korching Sim, Lili Asma Ismail | | Malaysian Journal of Medicine and Health Sciences. 2023; 19(6): 263 | | [Pubmed] | [DOI] | | 10 |
IMPULSE Study: Impact of COVID-19 in the present of ophthalmology focusing on ocular surface and future trends |
|
| J.M Benítez del Castillo, N. Alejandre Alba, I. Henares, M.P. Ferraris, M. Águila | | Archivos de la Sociedad Española de Oftalmología (English Edition). 2023; | | [Pubmed] | [DOI] | | 11 |
Effects of Carboxymethylcellulose Artificial Tears on Ocular Surface Microbiome Diversity and Composition, A Randomized Controlled Trial |
|
| Yujia Zhou, Gurjit S. Sidhu, Joan A. Whitlock, Bishoy Abdelmalik, Zachary Mayer, Youlei Li, Gary P. Wang, Walter A. Steigleman | | Translational Vision Science & Technology. 2023; 12(8): 5 | | [Pubmed] | [DOI] | | 12 |
Impact of Covid-19 on Pediatric Ophthalmology Care: Lessons Learned |
|
| Kirandeep Kaur, Janani Muralikrishnan, Jameel Rizwana Hussaindeen, Nilutparna Deori, Bharat Gurnani | | Pediatric Health, Medicine and Therapeutics. 2023; Volume 14: 309 | | [Pubmed] | [DOI] | | 13 |
Impacto de la pandemia por covid-19 en la decisión de los pacientes sometidos a cirugía refractiva en una institución privada en Bogotá, Colombia |
|
| Juliana Palacio Varona, Brian Pérez Riaño, María Paula Castro Mora, María Andrea Estevez Florez, Luis Guillermo Isaza Gómez, Diana V. Rey-Rodríguez | | Ciencia y Tecnología para la Salud Visual y Ocular. 2023; | | [Pubmed] | [DOI] | | 14 |
Face Mask and Tear Film Stability: A Pilot Study of the Objective Measurement of Tear Break-Up Time |
|
| Karim Mohamed-Noriega, David E. Charles-Cantu, Jibran Mohamed-Noriega, Braulio H. Velasco-Sepúlveda, Fernando Morales-Wong, Gerardo Villarreal-Méndez, Jesús Mohamed-Hamsho | | Journal of Clinical Medicine. 2023; 12(24): 7727 | | [Pubmed] | [DOI] | | 15 |
Effect of Wearing Face Mask as COVID-19 Protection on Spectacle-Fitting Variables |
|
| Hyung-Min Park, Byoung-Sun Chu | | Journal of Korean Ophthalmic Optics Society. 2023; 28(4): 289 | | [Pubmed] | [DOI] | | 16 |
TFOS lifestyle: Impact of contact lenses on the ocular surface |
|
| Lyndon Jones, Nathan Efron, Kalika Bandamwar, Melissa Barnett, Deborah S. Jacobs, Isabelle Jalbert, Heiko Pult, Michelle K. Rhee, Heather Sheardown, Joseph P. Shovlin, Ulli Stahl, Adriana Stanila, Jacqueline Tan, Silvia Tavazzi, Omur O. Ucakhan, Mark D.P. Willcox, Laura E. Downie | | The Ocular Surface. 2023; | | [Pubmed] | [DOI] | | 17 |
Estudio IMPULSO: impacto de la COVID-19 en el presente de la oftalmología centrada en superficie ocular y tendencias de futuro |
|
| J.M. Benítez del Castillo, N. Alejandre Alba, I. Henares, M.P. Ferraris, M. Águila | | Archivos de la Sociedad Española de Oftalmología. 2023; | | [Pubmed] | [DOI] | | 18 |
The effects of facial mask use on ocular surface parameters and tear film cytokine profile in prolonged use |
|
| Aysegul Penbe, Murat Oklar, Hatice Selen Kanar, Müberra Zülal Bayrak, Basak Ersari, Mustafa Talan, Raziye Dönmez Gün, Asuman Orçun, Saban Simsek | | International Ophthalmology. 2023; | | [Pubmed] | [DOI] | | 19 |
The effect of day-long mask wearing on non-invasive break-up time |
|
| Serdar Bilici, Aydin Toprak, Cagatay Buyukuysal, Suat H. Ugurbas | | Graefe's Archive for Clinical and Experimental Ophthalmology. 2022; | | [Pubmed] | [DOI] | | 20 |
Impact of prolonged face mask wearing on tear break-up time and dry eye symptoms in health care professionals |
|
| Mine Esen Baris, Suzan Guven Yilmaz, Melis Palamar | | International Ophthalmology. 2022; | | [Pubmed] | [DOI] | | 21 |
Altered Ocular Surface Health Status and Tear Film Immune Profile Due to Prolonged Daily Mask Wear in Health Care Workers |
|
| Sharon D’Souza, Tanuja Vaidya, Archana Padmanabhan Nair, Rohit Shetty, Nimisha Rajiv Kumar, Anadi Bisht, Trailokyanath Panigrahi, Tejal S. J, Pooja Khamar, Mor M. Dickman, Ruchika Agrawal, Sanjay Mahajan, Sneha Sengupta, Rudy M. M. A. Nuijts, Swaminathan Sethu, Arkasubhra Ghosh | | Biomedicines. 2022; 10(5): 1160 | | [Pubmed] | [DOI] | | 22 |
Effects of Calf Blood-Deproteinized Extract Ophthalmic Gel Combined with Sodium Hyaluronate Eye Drops on Conjunctival Hyperemia Score and Tear Film Stability in Patients with Dry Eye |
|
| Hao Wang, Dong Zhou, Zhuo Sun, Shanshan Sun, Guohua Deng, Muhammad Zubair Asghar | | Computational Intelligence and Neuroscience. 2022; 2022: 1 | | [Pubmed] | [DOI] | | 23 |
Visual health and prevalence of dry eye syndrome among university students in Iraq and Jordan |
|
| Dina M. Abdulmannan, Abdallah Y. Naser, Omar khaleel Ibrahim, Abdullah Shakir Mahmood, Jamal Alyoussef Alkrad, Kanar Sweiss, Hamzeh Mohammad Alrawashdeh, Angga Prawira Kautsar | | BMC Ophthalmology. 2022; 22(1) | | [Pubmed] | [DOI] | | 24 |
Capsanthin from
Capsicum annum
fruits exerts anti-glaucoma, antioxidant, anti-inflammatory activity, and corneal pro-inflammatory cytokine gene expression in a benzalkonium chloride-induced rat dry eye model
|
|
| Velmurugan Shanmugham, Ravi Subban | | Journal of Food Biochemistry. 2022; | | [Pubmed] | [DOI] | | 25 |
Impact of COVID-19 pandemic on the ocular surface |
|
| Ana Marta, Joao Heitor Marques, Daniel Almeida, Diana José, Paulo Sousa, Irene Barbosa | | World Journal of Clinical Cases. 2022; 10(27): 9619 | | [Pubmed] | [DOI] | | 26 |
Ocular Surface Changes Associated with Face Masks in Healthcare Personnel during COVID-19 Pandemic |
|
| Filippo Tatti, Lorenzo Mangoni, Simone Pirodda, Giuseppe Demarinis, Claudio Iovino, Emanuele Siotto Pintor, Germano Orrù, Luigi Isaia Lecca, Marcello Campagna, Gloria Denotti, Enrico Peiretti | | Life. 2022; 12(10): 1491 | | [Pubmed] | [DOI] | | 27 |
Association between dry eye disease and depression: An umbrella review |
|
| Ching-Yao Tsai, Zhu Liduzi Jiesisibieke, Tao-Hsin Tung | | Frontiers in Public Health. 2022; 10 | | [Pubmed] | [DOI] | | 28 |
Interrupted femtosecond laser delivery secondary to face mask–related fogging |
|
| Mahipal S. Sachdev, Raghav Malik, Gitansha Shreyas Sachdev, Anagha Heroor, Bharat R. Thoumungkan | | Journal of Cataract and Refractive Surgery Online Case Reports. 2022; 10(1): e00065 | | [Pubmed] | [DOI] | | 29 |
La superficie ocular tras 2 años de pandemia por COVID-19 |
|
| Braulio H. Velasco-Sepúlveda, Karim Mohammed-Noriega | | Revista Mexicana de Oftalmología. 2022; 96(4S): 186 | | [Pubmed] | [DOI] | | 30 |
Face mask use and effects on the ocular surface health: A comprehensive review |
|
| Barbara Burgos-Blasco, Pedro Arriola-Villalobos, Jose Ignacio Fernandez-Vigo, Carlos Oribio-Quinto, Mayte Ariño-Gutierrez, David Diaz-Valle, Jose Manuel Benitez-del-Castillo | | The Ocular Surface. 2022; | | [Pubmed] | [DOI] | | 31 |
Olho seco e COVID-19: uma revisão narrativa |
|
| Carlos Eduardo Ximenes da Cunha, Laís Rytholz Castro, Vitória Palazoni Viegas Mendonça, Eugênia Mirza de Queiroz Ferreira Barboza da Silveira, Iris Lopes Veras, Marina Viegas Moura Rezende Ribeiro | | Revista Brasileira de Oftalmologia. 2022; 81 | | [Pubmed] | [DOI] | | 32 |
The Effects of Face Mask Usage on Ocular Structures in Children During the COVID-19 Pandemic |
|
| Bediz Özen, Hakan Öztürk | | The Journal of Pediatric Research. 2022; 9(3): 292 | | [Pubmed] | [DOI] | | 33 |
Impact of Taping The Upper Mask Edge On Ocular Surface Stability and Dry Eye Symptoms |
|
| Sridevi Nair, Manpreet Kaur, Ramkishor Sah, Jeewan S. Titiyal | | American Journal of Ophthalmology. 2022; 238: 128 | | [Pubmed] | [DOI] | | 34 |
Intricate scientometric analysis and citation trend of COVID-19-related publications in Indian Journal of Ophthalmology during COVID-19 pandemic |
|
| Kirandeep Kaur, Bharat Gurnani | | Indian Journal of Ophthalmology. 2021; 69(8): 2202 | | [Pubmed] | [DOI] | | 35 |
Impact on refractive surgery due to increasing use of personal protection equipment: Insights from EUROCOVCAT group |
|
| Arthur B Cummings, Cian Gildea, Antoine P Brézin, Boris E Malyugin, Ozlem Evren Kemer, Omid Kermani, Isabel Prieto, Robert Rejdak, Miguel A Teus, Daniele Tognetto, Sandrine Zweifel, Mario D Toro | | European Journal of Ophthalmology. 2021; 31(6): 2789 | | [Pubmed] | [DOI] | | 36 |
The Effect and the Mechanism of Comprehensive Treatment on the Ocular Surface and the Visual Quality of Online Teachers with a Mild-to-Moderate Dry Eye Condition During the Early Phase of Coronavirus Disease 2019 |
|
| Yan-Xi Wang, Gang-Jin Kang, Juan Zhou, Kai-Ming Li, Man-Hua Xu | | International Journal of General Medicine. 2021; Volume 14: 6787 | | [Pubmed] | [DOI] | | 37 |
Problematic Internet Use Associated with Symptomatic Dry Eye Disease in Medical Students from Peru |
|
| I Benjamin Condori-Meza, L Alessandra Dávila-Cabanillas, Mabel R Challapa-Mamani, Antony Pinedo-Soria, Renato R Torres, Joel Yalle, Ricardo Rojas-Humpire, Salomón Huancahuire-Vega | | Clinical Ophthalmology. 2021; Volume 15: 4357 | | [Pubmed] | [DOI] | | 38 |
Influence of Face Masks on the Use of Contact Lenses |
|
| Clara Martinez-Perez, Bruno Monteiro, Mafalda Soares, Fatima Portugues, Sonia Matos, Ana Ferreira, Cristina Alvarez-Peregrina, Miguel Ángel Sánchez-Tena | | International Journal of Environmental Research and Public Health. 2021; 18(14): 7407 | | [Pubmed] | [DOI] | | 39 |
COVID-19: Update on Its Ocular Involvements, and Complications From Its Treatments and Vaccinations |
|
| Timothy P.H. Lin, Chung-Nga Ko, Ke Zheng, Kenny H.W. Lai, Raymond L.M. Wong, Allie Lee, Shaochong Zhang, Suber S. Huang, Kelvin H. Wan, Dennis S.C. Lam | | Asia-Pacific Journal of Ophthalmology. 2021; 10(6): 521 | | [Pubmed] | [DOI] | | 40 |
A Narrative Review of Current Understanding and Classification of Dry Eye Disease with New Insights on the Impact of Dry Eye during the COVID-19 Pandemic |
|
| Stefano Barabino | | Ophthalmology and Therapy. 2021; 10(3): 495 | | [Pubmed] | [DOI] | | 41 |
Impact of the COVID-19 Pandemic on Refractive Surgery |
|
| Matthew Bickford, Karolinne Rocha | | Current Ophthalmology Reports. 2021; | | [Pubmed] | [DOI] | |
|
|
|
|