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Research Article | Volume 12 Issue 1 (October-December, 2023) | Pages 13 - 19

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

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1
Eye center, Prince Mohammed bin Nasser Hospital, Ministry of Health, Jazan, Saudi Arabia.
2
Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia.
3
Faculty of Medicine, Jazan University, Saudi Arabia.
4
Department of Internal Medicine, Ministry of Health, Jazan, Saudi Arabia.
Under a Creative Commons license
Open Access
Received
Aug. 12, 2023
Accepted
Nov. 1, 2023
Published
Nov. 16, 2023

Abstract

Background: One of the most important defenses against the COVID-19 pandemic is the use of facemasks. Long-term facemask use can result in mask-associated dry eyes. This study explored the prevalence of face mask-associated dry eyes (MADE) and associated factors among health workers in Jazan. Methods: This prospective cross-sectional clinical study was carried out among healthcare workers (Physicians, Dentists, Pharmacists, Technicians, Nurses, and Administrative staff) who wore facemasks during duties at Prince Mohammed Bin Nair Hospital in Jazan, Sudi Arabia, from 2020 to 2022. Two hundred ninety-eight participants were randomly selected. The participants were given a questionnaire about their socio-demographic characteristics, occupational information, health information, and the duration they had used glasses, masks, and technological devices. The daily average quantity of time spent sleeping was also investigated. The severity of dry eye disease was determined using OSDI scores. The chi-square test and Fisher's exact test examined categorical variable connections. Mean differences were calculated using an independent \(t\)-test. Logistic regression will discover COVID-19 severity predictors. A statistically significant P-value is \(< 0.050\). Result: Among 298 health workers in this study fulfilling the inclusion criteria. The mean age of the respondents was \(32.50 \pm 7.46\) years old, consisting of 61.3% male and 38.7% female out of 298 respondents whom the majority of them were Saudi (89.6%) and the rest non-Saudi (10.4%). Based on the Ocular Surface Disease Index (OSDI) score, almost half of the respondents (49.0%) obtained an average score in terms of dry eye disease. Only gender and marital status were significantly associated with OSDI score \(( 2 = 24.247, p< 0.001\) and \(2 = 24.247, p< 0.05\) respectively). From the Health Information provided, most of the variables were significantly associated with the OSDI score. Conclusion: This study concluded that face mask-associated dry eye (MADE) prevalence among health practitioners stands at 51%, partly explaining the worsening dry eye disease symptoms among mask wearers.

Keywords
COVID-19; Dry eye; Face mask; Healthcare workers

INTRODUCTION

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.

 

Materials and Methods

RESULTS

DISCUSSION

CONCLUSION

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