Ricerc@Sapienza

Purpose: The aim of this study was to explore whether prolonged and consistent face mask use might be
associated with worsening of dry eye symptoms in patients with dry eye disease (DED). Methods: Subjects
with a previous diagnosis of DED. Their OSDI scores were compared with those recorded in Fall 2019
using the Wilcoxon paired test. Participants were stratified by face mask use: heavy (Group A) or
standard (Group B) face mask users. Heavy use was defined as wearing any type of face mask for at least
6 hours a day, at least 5 days per week in the last 2 months. Results: 67 subjects (mean age: 45.27 ± 10.06
SD years, 40% males and 60% females). Median OSDI score in Fall 2019: 18.75. Median OSDI in Spring
2020: 20.83. The Hodges‑Lehmann median difference was 2.09 (95% CI [1.05, 4.17]) (P < 0.0001). The
population was then stratified into heavy and standard face mask users: Group A included heavy users
(31 subjects; mean age: 42.81 ± 10.48 SD years; 35% males and 65% females), Group B included standard
users (36 subjects; mean age: 47.39 ± 9.31 SD years; 44% males and 56% females). The Hodges‑Lehmann
median difference was 5.21 (95% CI [3.13, 7.29]) in Group A (P < 0.0001), and 1.04 (95% [0, 2.08]) in Group
B (P = 0.0177). Conclusion: Prolonged and consistent face mask use is associated with an increase in
OSDI scores. Whether face mask use is responsible for the worsening of symptoms of DED remains to be
elucidated