Wearing a face mask is an important part of preventing the spread of COVID-19, but masks can come with some not-so-great side effects like maskne, foggy glasses, and general irritation around your face. Now, there’s a new side effect to have on your radar: mask-associated dry eye.
A report published in the journal Ophthalmology and Therapy on July 15 details how there has been an increase in cases of eye irritation and dry eye among people who regularly wear masks. The report’s authors, who are researchers at the University of Utah, note that they have seen “a marked increase in dry eye symptoms among regular mask users at multiple local clinics.” The patients include people who have never struggled with dry eye in the past, they point out, and those who use masks regularly for longer periods of time seem to be more likely to develop symptoms. The Centre for Ocular Research & Education (CORE) also issued an alert to practitioners on August 31 warning of mask-associated dry eye, along with information on how to relieve the condition.
This news "has important implications on eye health and infection prevention, as mask use is likely to continue for the foreseeable future,” according to the University of Utah researchers. But before you resign yourself to dealing with yet another issue due to #MaskLife, know this: You can do something about mask-associated dry eye. Here’s what you need to know.
What is dry eye, again?
Backing up for a moment: Dry eye is a condition that happens when the amount or quality of your tears isn’t sufficient, per the National Eye Institute (NEI). This can happen if there’s a problem with any of the components of your tear film, which is made up of several layers.
Dry eye is common—the NEI says it affects nearly 5 million Americans—and it can cause unpleasant symptoms, including:
- A scratchy feeling, like there’s something in your eye
- Stinging or burning feelings in your eye
- Red eyes
- Sensitivity to light
- Blurry vision
The condition can be caused by a slew of different things, including taking certain medications, having laser eye surgery, being exposed to windy, smoky, or dry environments, and looking at screens for too long, the NEI says.
So how can a face mask cause dry eye?
Mask-associated dry eye is a new condition, and the study’s researchers even point out that there’s no scientific literature on this. So, the exact cause of this hasn’t been studied.
However, there are some theories. One cited by the report’s authors is that this mask-induced dry eye is caused by an airflow issue. When you breathe out and your mask doesn’t have a tight fit, air can flow up and across the surface of your eyes. That encourages evaporation and can ultimately dry out your eyes. (It’s kinda like how having your AC vents blow directly into your eyeballs can dry them out.)
But the report’s authors also noted that people who use taped masks for a better seal also had eye issues. Their guess: The tape itself may interfere with the lower eyelid’s normal functioning, leading to dry eye.
An improper mask fit can even interfere with your eyelids’ ability to do their job. “Some doctors have also noted that the masks can pull down the lower eyelids slightly, making it difficult for normal blinking to restore the healthy surface of the eye,” Aditya Kanesa-thasan, MD, a corneal specialist at Wills Eye Hospital, tells Health.
Is there any way to prevent or treat mask-associated dry eye?
Dry eye can be a painful issue and how concerned about this you should be ultimately “depends on the severity of the symptoms,” Vivian Shibayama, O.D., an optometrist with UCLA Health, tells Health. Meaning, if you’ve been wearing masks all day and have had no issues, you’re probably fine. But if you’ve been struggling with sudden dry eye symptoms and they’re disruptive, you probably want to take action, ideally sooner rather than later.
The first step to helping relieve any eye issues you may have is to make sure your mask fits well, Dr. Shibayama says. Looking for a mask with a nose bridge that you can mold to your face and adjustable ear loops can help ensure a tighter fit. If that doesn’t work, Dr. Kanesa-thasan recommends folding a tissue into a roll and tucking it under the top of the mask to “add an extra cushion to the top edge of the mask and prevent air from escaping, similar to placing a towel under the door to avoid a draft.” You can also try to use medical tape to seal your mask across your nose, Dr. Kanesa-thasan says. “Take care to use the right tape for this to avoid skin irritation, and tape the mask to the cheek instead of the lower eyelid to maintain healthy blinking,” he says.
At night, you can use hot compresses on your eyes (wet a washcloth with warm or hot water, and lay it on your eyes for a few minutes). This can help stimulate your eyelid’s Meibomian glands—which are responsible for the oily outer layer of your tears—and push more oil out of the glands, Dr. Shibayama says. And, with more oil in your tears, the lubrication on your eyes should be less likely to evaporate as quickly.
Using lubricating eye drops a few times a day may also help, Dr. Shibayama says. “Oil-based lubricants may be more effective—they help with tear evaporation,” she says. However, she points out, these only work if you don’t wear contacts.
If your mask-associated dry eye is severe, wearing sealed goggles, like Ziena’s moisture chamber eyecups, may help, Dr. Shibayama says. “If fit properly, it keeps moisture in and the virus out,” she says. And if you’re still struggling, your eye doctor may recommend that you try a fluid-filled gas-permeable contact lens called a scleral lens to encase your eyes in fluid. “This gives the patient more consistent moisture throughout the day and also corrects vision,” Dr. Shibayama says.
Above all, talk to your eye doctor if you’re having issues with mask-associated dry eye. “I want to emphasize the importance of mask wearing, but that doesn’t mean you have to be uncomfortable,” Dr. Kanesa-thasan says.
The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.
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