Prevalence of Face Mask-Induced Dry Eye and Ocular Irritation Amid COVID-19 Among Health Workers in Jazan

Due to the advent of a new disease in December 2019 called Coronavirus Disease 2019 (COVID-19), caused by SARS-CoV-2 and initially diagnosed in Wuhan, the month has been notable for everyone (Hubei Province, China) [1]. The global trend away from mask use is accelerating in hospitals, where staff and patients must wear them for extended periods of time [2, 3]. Different viewpoints on the pandemic and its effects have cast doubt on the efficacy of facemasks in stopping the spread of the COVID-19 virus, but the WHO nevertheless recommends their usage. Cloth, surgical, and respirator face masks all have advantages over doing without any form of protection [4]. In June of 2020, an American ophthalmologist named D.E. White identified a new ailment he called ”mask-associated dry eye” (MADE) [5]. In a sample of 2,447 people who reported experiencing dry eye symptoms, 29% said that wearing a facemask made their condition worse [6]. Ocular surface inflammation and higher Ocular Surface Disease Index scores have been linked in other studies to prolonged and frequent facemask use [7, 8].

   The MADE prevalence was high among healthcare providers in Jeddah, Saudi Arabia (70.9%) [9]. They discovered a significant correlation between the use of facemasks and an increase in instances of severe dry eye symptoms. There were correlations between MADE and variables, including chronological age, occupational status, mask use duration, and time spent in front of electronic screens. This study found that donning a facemask worsened the symptoms of those with ocular disorders. Employees without a history of vision problems participated as well. According to a study from the Tear Film and Ocular Surface Dry Eye Workshop II (TFOS DEWS II), Dry eye disease (DED) is a complex ocular surface condition that disrupts tear film homeostasis and develops ocular symptoms. The causes include neurosensory abnormalities, unstable tear film and hyperosmolarity, ocular surface injury, inflammation, etc. [10]. Ocular pain, irritation, itching, and the sensation that something is stuck in the eye are all signs of dry eye disease [11]. The Ocular Surface Disease Index is the most often used patientreported outcome questionnaire for assessing the subjective symptoms of Dry eye diseases (DED) [12].

To combat the present COVID-19 pandemic, governments across the globe have mandated the use of face masks. In contrast, those who don masks tend to breathe through the mask’s top rather than their nose or mouth. It has been linked to increased tear film instability and accelerated hydration loss, both associated with eye irritation [13, 14]. As a result, during the COVID-19 pandemic, ocular irritation and dryness was observed in people who had never previously suffered from dry eyes [15, 16].

DED is one of the most common ocular surface conditions worldwide. A global epidemiological survey found that DED prevalence ranges from 5 to 64%. [17–19] In Al-Ahsa, Saudi Arabia, DED prevalence was 32.1% [20].

Due to the constant use of facial masks in the healthcare industry, dry eye syndrome is a significant concern for many individuals in this field. Objectives Determine the prevalence of facemask-induced dry eye and ocular irritation and its association with other risk factors that influenced this condition during the COVID- 19 pandemic among health workers in the Prince Mohammed Bin Nasser Hospital, Jazan, Saudi Arabia.