Around the world, there’s been at least some degree of reopening and a gradual return to regular routines in the wake of COVID-19. But one thing that has not completely disappeared is the use of facemasks, which has led to an increase in a new phenomenon known as mask-associated dry eye (MADE). Fortunately, there are many ways to help manage MADE, and contact lens wearers appear not to suffer any more than people who wear glasses,i which is good to know since wearing glasses with a facemask comes with the added inconvenience of lens fogging. Here, we’ll discuss strategies to manage MADE and help with safe and comfortable contact lens wearing experience as we adjust to the new “normal.”
A few factors contribute to the development of MADE. First, if your facemask is too loose or doesn’t sit properly, air escapes from the top.ii Under normal conditions, when you breath, air flows outward – but, when you wear a facemask with a gap at the top, air flows up. This upward airflow travels over the surface of your eyes, speeding up the evaporation of your protective tear film that helps to protect your eye from dryness symptoms.iii If you wear glasses, it also causes your lenses to fog up.iv Over time, this can lead to irritated, uncomfortable eyes,v even if you’ve never previously struggled with dryness symptoms.iv
To prevent this upward airflow and lens fogging, many people tape their masks to their faces or sit their masks up high on the nose. However, this can make symptoms worse because it can interfere with normal blinking and tug at the lower lid, leaving your eye more exposed to the drying air current.v,iii
Eye care professionals are certainly aware of these challenges and know what to look for. They also know which individuals are most at risk. This is one of many reasons why you should never miss your regular eye appointments. A research survey recently showed that a group of people ages 11 to 88 said they sometimes experience dry eye symptoms and, among them, 26.9% say wearing a face mask makes these symptoms worse.i Contact lenses may be a more convenient solution since they eliminate the hassle of spectacle fogging. That said, contact lenses should be worn responsibly and, with eyecare practices re-opening, you can now discuss any questions or concerns you may have with your eye care professional on the phone or in-person.
Tips for Healthy Contact Lens Wear
As always, replace your contact lenses on schedule as advised by your eye care professional. Never try to stretch out the life your lenses. This is essential under all circumstances. If you’re not wearing a one-day (daily disposable) contact lens, follow cleaning instructions carefully. In addition, the following tips can help:
- Facemasks can move around and be a bit of a bother but try to avoid touching your face since this can create additional problems.v
- Consider using a mask with a metal nose bridge that can be pinched to adjust the fit.iv
- Take a mask break when possible.
- Use contact lens rewetting drops. (Your eye care professional can advise you on an appropriate choice.)
- Avoid air vents where possible.
- Consciously force yourself to blink to allow your tear film and lipids to spread across the surface of your eyes.
In closing, if there is one thing we’ve learned from the pandemic, it’s that good hygiene matters. In other words, keep your face and eyelids clean, keep your mask clean, and keep your contact lenses clean. And, if you are experiencing any discomfort, contact your eye care professional for help.
i Boccardo L. Self-reported symptoms of mask-associated dry eye: A survey study of 3,605 people [published online ahead of print, 2021 Jan 20]. Cont Lens Anterior Eye. 2021;S1367-0484(21)00007-2. doi:10.1016/j.clae.2021.01.003
ii Giannaccare G, Vaccaro S, Mancini A, Scorcia V. Dry eye in the COVID-19 era: how the measures for controlling pandemic might harm ocular surface. Graefes Arch Clin Exp Ophthalmol. 2020;258(11):2567-2568. doi:10.1007/s00417-020-04808-3
iii Moshirfar M, West WB Jr, Marx DP. Face Mask-Associated Ocular Irritation and Dryness. Ophthalmol Ther. 2020;9(3):397-400. doi:10.1007/s40123-020-00282-6
iv https://www.ophthalmologytimes.com/view/mask-up-and-dry-out, accessed June 1, 2021.
v 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(2):448-449. doi:10.4103/ijo.IJO_3250_20