While wearing a mask is important in helping to reduce the spread of COVID-19, it can impact ocular comfort. First coined by an Ophthalmologist in the US, this particular sequelae has been termed mask associated dry eye, or ‘MADE’.1 If the top edge of the face mask is not sitting snugly against the face, exhaled air is forced up and out of the top of the mask. Consistent movement of air over the ocular surface promotes increased evaporation of the tear film. Over a period of time, the resulting thinner and less stable tear film can lead to drying of the ocular surface.2 Clinically, increased ocular surface staining may be seen.2 Subjectively, the mask-wearer may report irritated, uncomfortable, red, dry-feeling eyes.2
To reduce its occurrence, the first step is to ensure a good fit can be achieved, particularly along the top edge of the mask. The top edge can be secured with surgical tape to help further reduce air flow if required. Additional advice relates to balancing exposure to other drying situations whilst wearing the mask. This might mean giving patients advice to take visual breaks from looking at digital devices more frequently when the mask is on, and trying to limit time in air conditioned environments where possible. Given that these environmental changes may not be possible for some, use of artificial tear drops may be advisable to help alleviate symptoms. All of these tips are available in the downloadable infographic below, with further versions available in more than thirty languages, at COVIDEyeFacts.org
