You’re not imagining it: Masks can make your eyes feel dry

Allyson Chiu

THE WASHINGTON POST – When the elderly man came in to see Ohio-based ophthalmologist Darrell White in early May complaining of a burning sensation in his eyes and occasional blurry vision, White knew exactly what he was dealing with – another case of dry-eye syndrome.

What didn’t entirely make sense, though, was that White, a dry-eye expert, had been caring for the man for 20 years, and not once had his patient shown any symptoms of the common condition.

Then as White looked at the man, who was wearing a face mask, a familiar pandemic-era accessory, he was hit with a “lightbulb moment”.

“With each breath, his glasses were fogging and unfogging, fogging and unfogging,” White said. “That was the ‘aha’ moment for me.”

The sight of the man’s steamed-up glasses coupled with his sudden onset of eye dryness are both signs of what White is calling “mask-associated dry eye” (MADE) – an emerging phenomenon amid the novel coronavirus pandemic that eye experts are now urging the public to be mindful about.

“The real reason for bringing this to people’s attention is to say, ‘Hey, if you notice this, this is why it’s happening and let’s help you manage your dry eye while you continue to wear your mask’,” said Director Lyndon Jones at the University of Waterloo’s Center for Ocular Research and Education in Canada. “We would hate for people to use this as an excuse to not wear their masks.”

Dry eye can cause discomfort, blurred vision and redness, among other symptoms. Between 20 per cent and 25 per cent of people worldwide report dry eye at some point in their lives, and the problem is more likely as we age, Jones said.

But in recent months, some eye-care providers have reported an uptick in patients – both who wear glasses and those who don’t – wondering why their eyes feel drier than usual, especially while wearing masks.

White described the mask-associated dry eye as an “accelerant” for symptoms, particularly in people who either already have the condition or have a higher chance of developing it. One such at-risk group would be people who spend a lot of time staring at screens, White said – for instance, those of us who have now been working from home for months.

Research has shown that when people look at screens they blink less or fail to blink completely, resulting in dry or irritated eyes. But that uncomfortable feeling is easily avoidable, experts said. Here’s what they recommend.

FIND A MASK THAT FITS PROPERLY

An ill-fitting or poorly made face covering will increase the chances that exhaled air escapes from the top of the mask, said Professor of Ophthalmology at Northwestern University’s Feinberg School of Medicine Surendra Basti.

“Ideally, a mask should have a metal strip at the top incorporated in the mask so that you can push it and it takes the contour of your nose and cheekbones,” Basti said. That way the top edge of the mask sits flush with your face and more effectively blocks airflow, he said.

PROACTIVELY TAKE CARE OF DRY-EYE- SYMPTOMS

We often end up ignoring the discomfort or blurred vision until our eyes are “screaming at us,” Steinemann said. Instead, it’s important to pay attention to how your eyes are feeling and be committed to treating the symptoms.

One common way to alleviate dryness is a simple method Steinemann calls “20-20-20”.
“Every 20 minutes for 20 seconds, just 20 seconds, give yourself a break and look 20 feet away from the computer,” he said.

Briefly taking off the covering is another option as long as you are alone or it is otherwise safe to do so, Steinemann said.

Over-the-counter artificial tear drops (without preservatives) are also effective, Basti said.
Those drops should not be confused with redness relievers, which eye experts do not recommend, Steinemann said.

“When you put it on the eye, the vessels will shrink, but then the effect wears off,” he said, resulting in a rebound effect that can cause “real swollen blood vessels on the white of the eye”.

FIGHT THE URGE TO RUB YOUR EYES

While the novel coronavirus has made face touching a universal no-no, eye doctors have long been discouraging people from touching their eyes.

“The temptation is to close your eyes and rub them, and 99.9 per cent of the time that turns out to be a super-bad idea,” White said.

Eye rubbing can lead to a host of problems including micro-abrasions in the cornea and inflammation that may make your eye more swollen, he said.

“Hopefully, the possibility of getting COVID will make people do all the right things by not touching their eyes,” he said. “Not touching your eyes is good policy every day of the week, every week of the year, every year.”

KEEP WEARING YOUR MASK

Eye dryness, while annoying, is not going to pose serious problems for a majority of people, Jones said. So don’t stop wearing your mask out of concern that it might make your eyes feel dry, he said.

“I wouldn’t want people to think, ‘Oh my goodness, I can’t wear my mask because it’s going to produce this terrible situation’,” he said. “That’s blowing it way out of proportion.”

The benefits of mask-wearing also outweigh the eye discomfort, Basti said.

“The mask serves many purposes, which are much bigger than the eye symptoms,” he said, noting that the various ways to manage dry eye are better than just going without a mask.

“At least they don’t put other people at risk,” he said.