Evaluation of Masked Associated Dry Eyes using AS-OCT Tear Meniscus Parameters and OSDI Scores

ABSTRACT

Purpose: The purpose of this study is to determine the effect of prolonged use of a surgical mask on tear meniscus parameters using anterior segment ocular coherence tomography (AS-OCT) and Ocular Surface Disease Index (OSDI) score amongst healthcare workers during the COVID-19 pandemic. Methods: Fifty healthcare workers from St. Joseph's Healthcare Hamilton in the Hamilton Regional Eye Institute Department, Hamilton, Ontario participated in the study. All participants completed OSDI Questionnaire and provided demographics data. Participants had an average of three AS-OCT imaging of the tear meniscus (TM) at baseline and 8hrs later, after their regular shift. During this 8hr period, participants were required to wear medical masks continuously throughout their shift. Data was analyzed using SPSS V27. Results: Participants' (n = 50) mean age was 38.9 ± 12.9 years;22.0% were male and 78.0% were female. Of these participants, 62.0% wear spectacles and 28.0% wear contact lens. 54.4% of participants (n = 100 eyes) had normal OSDI scores of <12, 34.0% had mild OSDI scores, 4.0% had moderate OSDI scores, 8.0% had severe OSDI scores. Baseline mean ASOCT TM height was 385.4±172.6 μm and mean TM area was 46,496.7±41,875.5 μm ;after 8 hours shift the parameters reduced to mean TM height of 296.6±99.9 μm and mean TM area of 28,187.8±18,761.3 μm . With the resultant mean TM height and area difference of 88.8±142.8 μm (p<0.001) and 18,308.9±35,901.9 μm (p<0.001), respectively. Participants had a mean reduction in tear meniscus parameters in left eye (TM height 90.1±149.3 μm and TM area18,290.9±39,538.78 μm ) and right eye (TM height 87.5±137.5 μm and TM area 18,326.9±32,262.7 μm ), regardless of OSDI scores and significance between the left and right eye (Area Difference p=0.996;TMH Difference p=0.927). Conclusions: This study shows that prolonged use of medical mask especially during COVID-19 may reduce tear meniscus parameters. There was a 23.0% reduction in tear meniscus height and 39.4% reduction in tear meniscus area compared to the initial parameters, regardless of the presence of OSDI scores.