JULY 2021 | EYEWORLD | 105
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convection of air through their face mask,
affecting their tear film. … As a result, their tear
film breaks up sooner and that can, over the
course of a few hours, cause more problems,"
Dr. Moshirfar said.
Dr. Moshirfar noted that many patients who
were taping their masks to achieve a better seal
to avoid fogging of their glasses actually showed
increased dry eye symptoms. How the masks
were taped in many cases, Dr. Moshirfar said,
compromised lower lid movement, leading to
more exposure of the eye over time.
Dr. Moshirfar said that ophthalmologists
should be aware of the risk factors that could
exacerbate problems from mask-associated dry
eye and provide patients with tips to avoid this.
He said to avoid masks that are too tight or
worn too high because they could impact lower
lid movement or push on orbital fat. If tape is
used, a hypoallergenic paper tape should be
applied on the upper portion of the mask and
placed on the face in a way that doesn't inter-
fere with lid movement or apply pressure. He
also advised increased use of artificial tears,
closing one's eyes for several minutes, and per-
forming blinking exercises at intervals through-
out the day.
Dr. Silkiss suggested wearing a mask with a
built-in nose clip, washing or changing the mask
daily, using a lid scrub, frequent hand washing,
and use of artificial tears.
Dr. Moshirfar said that ophthalmologists
should be on the lookout for patients who are at
a higher risk for dry eye and exposure keratopa-
thy with mask use and help them mitigate these
factors with proper wear.
References
1. CDC. When You've Been
Fully Vaccinated. www.cdc.gov/
coronavirus/2019-ncov/vaccines/
fully-vaccinated.html. Accessed
May 27, 2021
2. CDC. Your Guide to Masks.
www.cdc.gov/coronavirus/
2019-ncov/prevent-getting-sick/
about-face-coverings.html.
Accessed May 27, 2021
3. Silkiss RZ, et al. Increased in-
cidence of chalazion associated
with face mask wear during the
COVID-19 pandemic. Am J Oph-
thalmol Case Rep. 2021;22:101032.
4. Moshirfar M, et al. Face
mask-associated ocular irritation
and dryness. Ophthalmol Ther.
2020;9:397–400.
5. Chadwick O, Lockington
D. Addressing post-oper-
ative mask-associated dry
eye (MADE). Eye (Lond).
2021;35:1543–1544.
6. Boccardo L. Self-reported
symptoms of mask-associated
dry eye: A survey study of 3,605
people. Cont Lens Anterior Eye.
2021. Online ahead of print.
Relevant disclosures
Moshirfar: None
Silkiss: None
