Association between the mask-associated dry eye (MADE) and corneal sensations

Purpose: To determine the risk of mask-associated dry eye (MADE), we investigated the fluorescein tear break-up time (FBUT), ocular surface temperature and blood flow, along with corneal sensitivity in mask wearers. Methods: We enrolled 60 mask wearers (mean age, 27.1±5.2 years) and then measured FBUT, corneal temperature and conjunctival blood flow without wearing masks (no mask), with masks, and taped masks. We defined MADE as the condition in which dry eye symptoms appeared and the FBUT with mask was less than 5 sec. Results: FBUT with mask was significantly shorter compared to the no mask and taped mask groups (P<0.01 and P<0.05). Corneal temperature difference and Conjunctival blood flow difference became significantly higher after wearing a mask compared to after wearing a taped mask (P<0.01). Of the 60 subjects, 13 were diagnosed as MADE. Pain sensitivity and the Ocular Surface Disease Index (P<0.05 and P<0.01) were significantly higher in the MADE group, with the FBUT without masks (P<0.05) significantly shorter versus the non-MADE group. Conclusions: MADE may be associated with corneal hypersensitivity. Wearing masks decreased FBUT and increased ocular surface temperature and blood flow. Taping the top edge of masks prevented these changes. Fitting masks properly may reduce MADE risk.