Spring is here! The trees are blooming, the grass is turning green, we have cool air, and pollens in the air. We put away the fall clothes and do some spring cleaning….and an increase in dry eyes. Eye care professionals and many of our well-educated patients already know that dry eye can be exacerbated this time of year. Spring is one of the biggest factors to exacerbate dry eye symptoms, and during this time there is the presence of allergens, like pollen. One study found that in most cases, pollen was to blame for worsening symptoms during the spring months. If you have chronic dry eyes that get worse in spring, you may have allergies too. One of the things that may make people suffer more this year is the fact that wearing masks can also aggravate dryness.
An article published by Moshirfar et al. in Ophthalmology and Therapy in September 2020 said that “with COVID-19 and accompanying face mask use likely projecting well into the future, eye dryness, irritation and keratopathy from mask wear may become a problem for a large percentage of the population.” The authors go on to say that “in our community and patient population, we have seen a marked increase in dry eye symptoms among regular mask users at multiple local clinics. This group includes individuals who have never previously suffered from dry eyes. Individuals using masks regularly for an extended duration appear more likely to show symptoms. This group includes the elderly, immunocompromised, and clinic staff who wear masks almost full-time.”
It seems that as we exhale with a mask on only a limited amount of our breath passes forward through the mask, some air escapes through gaps in the masks on the bottom, the sides, and perhaps most pronounced, through the top of the mask since it may not be secured close enough to our face because of our nose. Masks come in a variety of shapes, sizes, and materials. Some have nose pieces built-in made of metal or another pliable material that can be bent to contour the shape and size of the wearer’s nose producing a better fit. However, for those masks that do not have a nose piece or for those masks that are improperly fit in some other way, exhaled air can be forced upwards towards our eyes. Moshirfar et al. postulate that “this increased airflow likely accelerates the evaporation of the tear film which, when continuous for hours or days, may result in ocular surface irritation or inflammation.”
Taping the mask to the nose may not offer a viable solution either. Moshirfar et al. tried this in their clinic with their post-op cataract patients and found that those patients still suffered dryness. They thought that perhaps the medical tape secured to the skin of the nose and upper cheek may have pulled the lower lid away from the eye inducing mild ectropion which can lead to dryness and keratopathy.
If you are experiencing dry eye symptoms contact us immediately.