Clinical Study On Mask-Associated Dry Eye In Post-Epidemic Era

Objective: To study the correlation of long-term masks wearing and dry eye in postepidemic era.Methods: 89 medical graduate students(178 eyes)aged 20-30 years from Yangzhou university affiliated hospital were included in the study from September 2021 to December 2021.A self-control study was conducted on the ocular surface status of subjects on the day of no mask wearing(group T1)and on the day of mask wearing(group T2).No mask days(rest status for 1 day or more,no masks wearing)and mask days(wear the mask continuously for 1 month,and wear the mask for more than 8 hours every day)were at least one-month interval.We used comprehensive anterior segment analyzer(SLE-6E Galaxy)to evaluate the tear meniscus height,tear-film break up time(BUT),lipid layer thickness level,conjunctival congestion level,ciliary congestion level,meibomian gland opening level and meibomian gland absence rate level.All the tests were non-invasive.and,all participants filled in ocular surface disease index questionnaire and Hamilton anxiety scale.We used SPSS 25.0 software for statistical analysis.Results: In total,89 participants completed all the examination and were included in the statistical analysis.There were 59 females(66.3%)and 30 males(33.7%)with the mean age of 25.49±2.71 years.There was no statistical difference for participants in T1 and T2 stage in electronics using time and sleep time(P > 0.05).The dry eye cases increased from 76 eyes(42.7%)in T1 group to 139 eyes(78.1%)in T2 group.The moderate and severe dry eye cases in T2 group were significantly higher than that in T1group(P < 0.001).Conjunctival congestion and ciliary congestion grades in T2 group were significantly higher than that in the T1 group(P < 0.001).The tear Meniscus height,first BUT and mean BUT in T2 group were lower than that in T1 group(P < 0.001).In addition,the proportion of normal eyelid margin glandular opening in T2 group decreased,while the proportion of mild and moderate abnormal eyelid margin glandular opening increased in T2 group(P < 0.001)and the rate of meibomian gland absence score in T2 group decreased(P < 0.001).What’s more,OSDI score in T2 group is significantly higher than that in T1 group(26.06 ± 10.13 vs 22.80 ± 8.31)(P = 0.02).However,no significant differences were found in lipid layer thickness and Hamilton Anxiety Scale scores between two groups(P > 0.05).Conclusion: Long-term masks wearing could increase conjunctival hyperemia,ciliary hyperemia and palpebral gland opening,meibomian gland deletion rate and OSDI score,decrease tear meniscus height,BUT,and surface tear film stability,resulting in the incidence of dry eye increased.The dry eye in subjects with long-term mask wearing were more severe than those without wearing mask.But most of the dry eyes were mild or moderate,and a few were severe.