Real or MADE-up: Investigating Mask-Associated Dry Eye (MADE) as an emerging syndrome

Mask-Associated Dry Eye (MADE) has emerged as a consequence of widespread face mask usage during the Covid-19 pandemic. This review critically assesses the available evidence. A comprehensive search on PUBMED and EMBASE was conducted to identify studies on MADE, which were then categorized based on...

Full description

Saved in:
Bibliographic Details
Published in:Eye (London) 2024-04, Vol.38 (6), p.1091-1096
Main Authors: Teo, Michelle Ai Ling, Sullivan, Eoin O’, Patel, Bhupendra C. K., Malhotra, Raman
Format: Article
Language:English
Subjects:
692/1807/1482
692/699/3161/3163
Cornea
COVID-19
Irritation
Laboratory Medicine
Masks
Medicine
Medicine & Public Health
Ophthalmology
Pandemics
Pharmaceutical Sciences/Technology
Review Article
Statistical analysis
Surgery
Surgical Oncology
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Mask-Associated Dry Eye (MADE) has emerged as a consequence of widespread face mask usage during the Covid-19 pandemic. This review critically assesses the available evidence. A comprehensive search on PUBMED and EMBASE was conducted to identify studies on MADE, which were then categorized based on their design. A total of 26 studies were critically appraised, with the majority exhibiting poor study design quality. Investigating the impact of mask use on ocular surface irritation faced challenges due to global mask mandates, pandemic-related behavioural changes, and a lack of validated methods to measure the response to mask wear. Among the 15 studies, 12 reported a statistically significant reduction in TBUT associated with mask wear; however, the median decrease of 1.3 s was considered clinically insignificant. Results from Schirmer’s test in 8 studies varied, with 5 studies reporting a decrease, contradicting the hypothesis of misdirected airflow. Out of 7 studies on corneal and conjunctival staining, 6 indicated a worsening associated with mask wear. Five studies investigating OSDI scores reported an increase following mask wear, but 3 studies repeated the survey too soon. Limited evidence suggests that masks may cause mild ocular surface irritation, but the quality and certainty of this evidence remain low. Methodological limitations were prevalent across the majority of studies, and the observed changes were minimal. Therefore, it is unlikely that significant ocular surface pathology will develop in the majority of mask wearers. Currently, there is insufficient data to support the establishment of a new syndrome.
ISSN:0950-222X
1476-5454
1476-5454
DOI:10.1038/s41433-023-02847-8