Assessment of dry eye disease in N95 versus surgical face mask wearers during COVID-19

Shirin Hamed Azzam, Amir Nama, Hanan Badarni, Helena Asael, Wadie Abu Dahoud, Michael Mimouni, Hiba Zayyad

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Purpose: Investigating the effect of different face masks on dry eye disease (DED) among healthcare workers during the COVID-19 pandemic. Methods: This was a comparative, cross-sectional study. Participants were included into two groups: group 1 (n = 30) wore surgical masks, and group 2 (n = 30) wore N95 masks with face shields. Demographic and ocular surface disease index questionnaires (OSDI) were performed. In addition, Tear break-up time (TBUT), corneal and conjunctival fluorescein staining, and meibography to assess meibomian gland loss (MGL) were performed on all participants. Independent T-test was used to compare continuous parameters and Chi-square test for categorical variables. The relationship between continuous variables was tested using bivariate Pearson correlation. Results: Sixty healthcare workers participated in this study (36 females and 24 males). The mean (±SD) age of the surgical mask and N95 groups was 35.33 (±14.94) and 36.63 (±10.64) years, respectively. Both masks caused dryness according to TBUT, MGL, and OSDI scores. DED per DEWS II definition was observed in 14 (46.7%) and 16 (53.3%) patients in groups 1 and 2, respectively. Comparing the two groups, N95 mask caused significantly more dryness according to TBUT (P = 0.042) and fluorescein staining (P = 0.038 for the right eye and P = 0.015 for the left eye). Conclusion: Physicians should be aware of the potential dry eye signs secondary to face mask wear during the COVID-19 pandemic. Further attention should be taken in patients who suffer from preexisting dry eye syndrome and in patients who undergo intraocular operations.

Original languageEnglish
Pages (from-to)995-999
Number of pages5
JournalIndian Journal of Ophthalmology
Issue number3
StatePublished - Mar 2022
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2022 Indian Journal of Ophthalmology Published by Wolters Kluwer-Medknow.


  • COVID-19
  • Dry eye disease
  • Face masks
  • N95 mask
  • Surgical mask


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