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Why face masks can make eyes feel dry, and what you can do about it

Why face masks can make eyes feel dry, and what you can do about it

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Face masks may increase the risk of dry, irritated eyes. (Shutterstock)

Face masks help reduce coronavirus transmission, which has prompted mandates and expert recommendations for their use where social distancing is difficult. As the world emerges from shutdowns, wearing face masks for extended periods of time in settings such as offices will increase.

While these protective measures are essential to combating COVID-19’s spread, a new phenomenon is emerging: increasing reports of dry, uncomfortable eyes. What is the science behind this trend, who is at risk and is there a solution?

Dry eye has become much better understood in recent years, thanks to colleagues from the Centre for Ocular Research & Education (CORE) at the University of Waterloo, the Tear Film and Ocular Surface Society and other researchers around the world. That knowledge provides a head start on deciphering this latest wrinkle.

Making sense of MADE: Mask-associated dry eye

The term mask-associated dry eye (MADE) was first described by an ophthalmologist in June based on increasing incidents in his office. Additional reports have since circulated, and a recent review further examined the issue.

People with existing dry eye disease report worsening symptoms — a problematic occurrence for the tens of millions of people worldwide who already struggle with the issue. Concurrently, previously asymptomatic patients are flagging uncomfortable eyes and variable vision for the first time, particularly when reading or using digital devices for a long period of time.

Our tear film’s delicate balance

When addressing MADE, it is helpful to understand our tear film, the liquid layer that coats the eye’s surface. This tiny volume of fluid, equivalent to one-tenth of a single water drop, has a highly complex structure and composition. It lubricates the surface of the eye, allowing smooth and comfortable passage of the eyelid during every blink. Ongoing imbalance in the tear film leads to dry eye disease.

Eyes feel sore, dry and irritated, and may water and look red.

Close-up of a very bloodshot blue eye
A sore, irritated, uncomfortable dry eye. (Shutterstock)

There are many causes of dry eye disease, including issues relating to eye and systemic health conditions, age, gender or medications. Excessive use of digital devices, poor indoor air quality and pollution all result in symptoms. Situations that increase how quickly the tear film evaporates, such as air-conditioned offices or automobile air-blowers, can quickly and significantly dry the eye’s surface, leading to more pronounced symptoms.

Masks, airflow and evaporation

Face masks significantly reduce the spread of air outwards from the mouth and nose. However, exhaled air still needs to disperse; when a mask sits loosely against the face the likely route is upwards. This forces a stream of air over the surface of the eye, creating conditions that accelerate the evaporation of the tear film, like a steady breeze blowing over damp skin.

People who wear glasses are well aware of this, shown by the annoying lens fogging that often occurs when breathing under a mask.

A woman wearing a face mask and eyeglasses with fogged-up lenses
Annoying, fogged-up spectacles due to a poor fitting mask. (Chau-Minh Phan/CORE, University of Waterloo), Author provided

When masks are worn for extended periods, this repeated evaporation may lead to dry spots on the ocular surface.

Similar effects have been reported with continuous positive airway pressure (CPAP) masks that are used to treat sleep apnea. Eye dryness may also result when face masks are taped to seal the top edge, if that interferes with the eyelids’ natural movement, preventing full blinks. Incomplete blinking can cause the tear film to become less stable.

Who may be affected?

In addition to those with pre-existing dry eye disease, the general mask-wearing population may find themselves wondering why their eyes are inexplicably irritated. This includes the elderly, who naturally have less efficient tears.

An extensive review demonstrated that wearing contact lenses does not raise the risk of contracting COVID-19, as long as people follow good hygiene and cleaning measures. However, a contact lens can disturb the tear film, potentially making wearers more MADE-susceptible if exhaled air further impacts tear film stability.

Prolonged use of face masks in air-conditioned locations may also trigger MADE. So too could increased digital device use while wearing masks — a rising trend during the pandemic.

Beyond discomfort, MADE presents another risk: it may encourage people to rub their face and eyes for temporary relief. Coronavirus transmission is possible via the mouth and nose, and, to a lesser extent, potentially the eyes. Bringing unwashed hands near the face may increase the likelihood of infection. That is an additional reason to tackle MADE.

Alleviating MADE

Several simple measures can help reduce the drying effects of upward air flow from masks.

Click for infographic on what causes MADE and how to alleviate it.

As with any new eye-related concern, first check with an eye care practitioner for advice and to rule out other causes.

Second, ensure that a mask is worn appropriately, particularly when wearing spectacles and sunglasses. A close-fitted mask, or carefully taped top edge that does not interfere with blinking, may help direct air flow downwards. This helps prevent lenses from steaming and reduces MADE.

Woman wearing a face mask and eyeglasses
Clear spectacles with a well fitting mask. (Chau-Minh Phan/CORE, University of Waterloo), Author provided

Lubricating drops may help with comfort. Eye care practitioners can recommend the best type, based on medical history and circumstances.

Limit time in air-conditioned or windy environments when wearing masks, and take regular breaks from digital devices.

Don’t ditch the mask

Is wearing a mask worth it, when you may have to possibly contend with MADE? Absolutely! Masks are here for the foreseeable future. Along with social distancing and hygiene measures, they represent a crucial part of our defence against the spread of COVID-19.

The good news is that we understand why MADE occurs and can address it. Remaining alert and following a few simple steps can help increase eye comfort and promote good mask wear, and with it, we move further along in overcoming the global pandemic.

Over the past 3 years, Lyndon Jones or his research group (CORE) has received research support or lectureship honoraria from Alcon, Allergan, CooperVision, GL Chemtec, iMed Pharma, J&J Vision, Lubris, Menicon, Nature’s Way, Novartis, Ote, PS Therapy, Safilens, Santen, Shire, SightGlass and Visioneering. He is also a consultant and/or serves on an advisory board for Alcon, CooperVision, J&J Vision, Novartis and Ophtecs.

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Supreme Court To Hear Arguments In Biden Admin’s Censorship Of Social Media Posts

Supreme Court To Hear Arguments In Biden Admin’s Censorship Of Social Media Posts

Authored by Tom Ozimek via The Epoch Times (emphasis ours),

The…

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Supreme Court To Hear Arguments In Biden Admin’s Censorship Of Social Media Posts

Authored by Tom Ozimek via The Epoch Times (emphasis ours),

The U.S. Supreme Court will soon hear oral arguments in a case that concerns what two lower courts found to be a “coordinated campaign” by top Biden administration officials to suppress disfavored views on key public issues such as COVID-19 vaccine side effects and pandemic lockdowns.

President Joe Biden delivers the State of the Union address in the House Chamber of the U.S. Capitol in Washington on March 7, 2024. (Mandel Ngan/AFP/Getty Images)

The Supreme Court has scheduled a hearing on March 18 in Murthy v. Missouri, which started when the attorneys general of two states, Missouri and Louisiana, filed suit alleging that social media companies such as Facebook were blocking access to their platforms or suppressing posts on controversial subjects.

The initial lawsuit, later modified by an appeals court, accused Biden administration officials of engaging in what amounts to government-led censorship-by-proxy by pressuring social media companies to take down posts or suspend accounts.

Some of the topics that were targeted for downgrade and other censorious actions were voter fraud in the 2020 presidential election, the COVID-19 lab leak theory, vaccine side effects, the social harm of pandemic lockdowns, and the Hunter Biden laptop story.

The plaintiffs argued that high-level federal government officials were the ones pulling the strings of social media censorship by coercing, threatening, and pressuring social media companies to suppress Americans’ free speech.

‘Unrelenting Pressure’

In a landmark ruling, Judge Terry Doughty of the U.S. District Court for the Western District of Louisiana granted a temporary injunction blocking various Biden administration officials and government agencies such as the Department of Justice and FBI from collaborating with big tech firms to censor posts on social media.

Later, the Court of Appeals for the Fifth Circuit agreed with the district court’s ruling, saying it was “correct in its assessment—‘unrelenting pressure’ from certain government officials likely ‘had the intended result of suppressing millions of protected free speech postings by American citizens.’”

The judges wrote, “We see no error or abuse of discretion in that finding.”

The ruling was appealed to the Supreme Court, and on Oct. 20, 2023, the high court agreed to hear the case while also issuing a stay that indefinitely blocked the lower court order restricting the Biden administration’s efforts to censor disfavored social media posts.

Supreme Court Justices Samuel Alito, Neil Gorsuch, and Clarence Thomas would have denied the Biden administration’s application for a stay.

“At this time in the history of our country, what the Court has done, I fear, will be seen by some as giving the Government a green light to use heavy-handed tactics to skew the presentation of views on the medium that increasingly dominates the dissemination of news,” Justice Alito wrote in a dissenting opinion.

“That is most unfortunate.”

Supreme Court Justice Samuel Alito poses in Washington on April 23, 2021. (Erin Schaff/Reuters)

The Supreme Court has other social media cases on its docket, including a challenge to Republican-passed laws in Florida and Texas that prohibit large social media companies from removing posts because of the views they express.

Oral arguments were heard on Feb. 26 in the Florida and Texas cases, with debate focusing on the validity of laws that deem social media companies “common carriers,” a status that could allow states to impose utility-style regulations on them and forbid them from discriminating against users based on their political viewpoints.

The tech companies have argued that the laws violate their First Amendment rights.

The Supreme Court is expected to issue a decision in the Florida and Texas cases by June 2024.

‘Far Beyond’ Constitutional

Some of the controversy in Murthy v. Missouri centers on whether the district court’s injunction blocking Biden administration officials and federal agencies from colluding with social media companies to censor posts was overly broad.

In particular, arguments have been raised that the injunction would prevent innocent or borderline government “jawboning,” such as talking to newspapers about the dangers of sharing information that might aid terrorists.

But that argument doesn’t fly, according to Philip Hamburger, CEO of the New Civil Liberties Alliance, which represents most of the individual plaintiffs in Murthy v. Missouri.

In a series of recent statements on the subject, Mr. Hamburger explained why he believes that the Biden administration’s censorship was “far beyond anything that could be constitutional” and that concern about “innocent or borderline” cases is unfounded.

For one, he said that the censorship that is highlighted in Murthy v. Missouri relates to the suppression of speech that was not criminal or unlawful in any way.

Mr. Hamburger also argued that “the government went after lawful speech not in an isolated instance, but repeatedly and systematically as a matter of policy,” which led to the suppression of entire narratives rather than specific instances of expression.

“The government set itself up as the nation’s arbiter of truth—as if it were competent to judge what is misinformation and what is true information,” he wrote.

In retrospect, it turns out to have suppressed much that was true and promoted much that was false.

The suppression of reports on the Hunter Biden laptop just before the 2020 presidential election on the premise that it was Russian disinformation, for instance, was later shown to be unfounded.

Some polls show that if voters had been aware of the report, they would have voted differently.

Tyler Durden Mon, 03/18/2024 - 09:45

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International

AI vs. elections: 4 essential reads about the threat of high-tech deception in politics

Using disinformation to sway elections is nothing new. Powerful new AI tools, however, threaten to give the deceptions unprecedented reach.

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Like it or not, AI is already playing a role in the 2024 presidential election. kirstypargeter/iStock via Getty Images

It’s official. Joe Biden and Donald Trump have secured the necessary delegates to be their parties’ nominees for president in the 2024 election. Barring unforeseen events, the two will be formally nominated at the party conventions this summer and face off at the ballot box on Nov. 5.

It’s a safe bet that, as in recent elections, this one will play out largely online and feature a potent blend of news and disinformation delivered over social media. New this year are powerful generative artificial intelligence tools such as ChatGPT and Sora that make it easier to “flood the zone” with propaganda and disinformation and produce convincing deepfakes: words coming from the mouths of politicians that they did not actually say and events replaying before our eyes that did not actually happen.

The result is an increased likelihood of voters being deceived and, perhaps as worrisome, a growing sense that you can’t trust anything you see online. Trump is already taking advantage of the so-called liar’s dividend, the opportunity to discount your actual words and deeds as deepfakes. Trump implied on his Truth Social platform on March 12, 2024, that real videos of him shown by Democratic House members were produced or altered using artificial intelligence.

The Conversation has been covering the latest developments in artificial intelligence that have the potential to undermine democracy. The following is a roundup of some of those articles from our archive.

1. Fake events

The ability to use AI to make convincing fakes is particularly troublesome for producing false evidence of events that never happened. Rochester Institute of Technology computer security researcher Christopher Schwartz has dubbed these situation deepfakes.

“The basic idea and technology of a situation deepfake are the same as with any other deepfake, but with a bolder ambition: to manipulate a real event or invent one from thin air,” he wrote.

Situation deepfakes could be used to boost or undermine a candidate or suppress voter turnout. If you encounter reports on social media of events that are surprising or extraordinary, try to learn more about them from reliable sources, such as fact-checked news reports, peer-reviewed academic articles or interviews with credentialed experts, Schwartz said. Also, recognize that deepfakes can take advantage of what you are inclined to believe.


Read more: Events that never happened could influence the 2024 presidential election – a cybersecurity researcher explains situation deepfakes


How AI puts disinformation on steroids.

2. Russia, China and Iran take aim

From the question of what AI-generated disinformation can do follows the question of who has been wielding it. Today’s AI tools put the capacity to produce disinformation in reach for most people, but of particular concern are nations that are adversaries of the United States and other democracies. In particular, Russia, China and Iran have extensive experience with disinformation campaigns and technology.

“There’s a lot more to running a disinformation campaign than generating content,” wrote security expert and Harvard Kennedy School lecturer Bruce Schneier. “The hard part is distribution. A propagandist needs a series of fake accounts on which to post, and others to boost it into the mainstream where it can go viral.”

Russia and China have a history of testing disinformation campaigns on smaller countries, according to Schneier. “Countering new disinformation campaigns requires being able to recognize them, and recognizing them requires looking for and cataloging them now,” he wrote.


Read more: AI disinformation is a threat to elections − learning to spot Russian, Chinese and Iranian meddling in other countries can help the US prepare for 2024


3. Healthy skepticism

But it doesn’t require the resources of shadowy intelligence services in powerful nations to make headlines, as the New Hampshire fake Biden robocall produced and disseminated by two individuals and aimed at dissuading some voters illustrates. That episode prompted the Federal Communications Commission to ban robocalls that use voices generated by artificial intelligence.

AI-powered disinformation campaigns are difficult to counter because they can be delivered over different channels, including robocalls, social media, email, text message and websites, which complicates the digital forensics of tracking down the sources of the disinformation, wrote Joan Donovan, a media and disinformation scholar at Boston University.

“In many ways, AI-enhanced disinformation such as the New Hampshire robocall poses the same problems as every other form of disinformation,” Donovan wrote. “People who use AI to disrupt elections are likely to do what they can to hide their tracks, which is why it’s necessary for the public to remain skeptical about claims that do not come from verified sources, such as local TV news or social media accounts of reputable news organizations.”


Read more: FCC bans robocalls using deepfake voice clones − but AI-generated disinformation still looms over elections


How to spot AI-generated images.

4. A new kind of political machine

AI-powered disinformation campaigns are also difficult to counter because they can include bots – automated social media accounts that pose as real people – and can include online interactions tailored to individuals, potentially over the course of an election and potentially with millions of people.

Harvard political scientist Archon Fung and legal scholar Lawrence Lessig described these capabilities and laid out a hypothetical scenario of national political campaigns wielding these powerful tools.

Attempts to block these machines could run afoul of the free speech protections of the First Amendment, according to Fung and Lessig. “One constitutionally safer, if smaller, step, already adopted in part by European internet regulators and in California, is to prohibit bots from passing themselves off as people,” they wrote. “For example, regulation might require that campaign messages come with disclaimers when the content they contain is generated by machines rather than humans.”


Read more: How AI could take over elections – and undermine democracy


This story is a roundup of articles from The Conversation’s archives.


This article is part of Disinformation 2024: a series examining the science, technology and politics of deception in elections.

You may also be interested in:

Disinformation is rampant on social media – a social psychologist explains the tactics used against you

Misinformation, disinformation and hoaxes: What’s the difference?

Disinformation campaigns are murky blends of truth, lies and sincere beliefs – lessons from the pandemic


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Government

Artificial mucus identifies link to tumor formation

NEW ORLEANS, March 18, 2024 – During cold and flu season, excess mucus is a common, unpleasant symptom of illness, but the slippery substance is essential…

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NEW ORLEANS, March 18, 2024 – During cold and flu season, excess mucus is a common, unpleasant symptom of illness, but the slippery substance is essential to human health. To better understand its many roles, researchers synthesized the major component of mucus, the sugar-coated proteins called mucins, and discovered that changing the mucins of healthy cells to resemble those of cancer cells made healthy cells act more cancer-like.

Credit: American Chemical Society

NEW ORLEANS, March 18, 2024 – During cold and flu season, excess mucus is a common, unpleasant symptom of illness, but the slippery substance is essential to human health. To better understand its many roles, researchers synthesized the major component of mucus, the sugar-coated proteins called mucins, and discovered that changing the mucins of healthy cells to resemble those of cancer cells made healthy cells act more cancer-like.

The researcher will present her results today at the spring meeting of the American Chemical Society (ACS). ACS Spring 2024 is a hybrid meeting being held virtually and in person March 17-21; it features nearly 12,000 presentations on a range of science topics.

“For hundreds of years, mucus was considered a waste material or just a simple barrier,” says Jessica Kramer, a professor of biomedical engineering who led the study. And indeed, it does serve as a barrier, regulating the transport of small molecules and particulates to underlying epithelial cells that line the respiratory and digestive tracts. But it also does much more. Studies show that mucus and mucins are biologically active, playing roles in immunity, cell behavior and defense against pathogens and cancer. Kramer’s team at the University of Utah, for example, recently found that specific sugars attached to mucins inhibited coronavirus infection in cell culture.

“Part of the challenge of studying mucus and mucins in general is that they have quite a variety of protein structures,” Kramer explains. Although humans share more than 20 mucin genes, those genes are expressed differently in different tissues and are spliced to generate a range of proteins. In addition, cells modify those proteins in myriad ways with different sugars to meet the body’s needs.

Complicating the picture, genetic factors alone don’t determine mucin composition. Dietary and environmental factors can also influence which sugars become attached to these proteins. Thus, mucus composition can vary significantly from person to person, from day to day, and from tissue to tissue, all of which makes it difficult to identify the biological effects of any given mucin.

To study mucin properties, researchers can collect mucus from animals in slaughterhouses, Kramer says. “But ultimately, it’s quite labor intensive and difficult to purify. And in the process of doing the harvesting, usually the sticky, slimy properties are disrupted.”

As an alternative, mucins can be purchased off-the-shelf, Kramer explains. But because batch-to-batch variability can lead to problems with experimental reproducibility, methods are needed to reliably produce synthetic mucins at scale and at a reasonable price.

In the absence of a simple genetic method to produce individual mucins, Kramer’s lab combined synthetic chemistry and bacterial enzymes to generate the core polypeptides and then selectively add sugars to create unique synthetic mucins. This allows the researchers to test the physical, chemical and biological properties of individual types of mucin molecules and identify the impact of changing individual sugars or protein sequences.

Kramer, along with the lab of collaborator Jody Rosenblatt at King’s College London, is applying her team’s mucins to questions of cancer biology. In particular, the scientists are exploring the influence of mucins on the earliest stages of tumor formation. Previous studies in other labs have shown that mucins embedded in the surface of cancer cells promote metastasis, the spread of cancer to other tissues in the body. These mucins can also help the cancer cells evade immune system defenses by blocking immune cell activation.

“We are building synthetic mucins to understand how the chemical aspects of these proteins affect the behavior of cancer cells,” Kramer explains. “It hasn’t been possible to study these things before because we can’t control the molecular properties of mucins using traditional genetic and biochemical methods.”

Normally, as non-cancerous epithelial cells grow, they crowd together, with some getting eliminated from the epithelial layer to maintain a consistent and stable tissue structure. When Kramer’s team engineered the cells to have a bulky mucin-rich surface similar to that of cancer cells, the cells stopped extruding normally and piled up, forming what looked like the start of tumors.

Kramer is quick to note, however, that her team has not determined whether the genetics of the cells have changed, so they cannot yet state definitively whether the healthy cells were transformed into cancer cells. Those studies are ongoing.

The insights will be pivotal for the development of possible cancer treatments targeting mucins, as they will help highlight which parts of the mucin molecules are most important to tumor formation.

Scientists have been trying to make mucin-targeting therapeutics for decades, but that hasn’t worked well, in part because the sugar groups on the molecules weren’t fully taken into account, Kramer says. “For a vaccine, we can’t only consider the protein sequence because that’s not what the molecule looks like to the immune system. Instead, when an immune cell bumps into the surface of a cancer cell it’s going to see the sugars first, not the protein backbone.” So she believes an effective vaccine will need to target those mucin sugars.

Beyond cancer, the ability to reliably modify the protein sequence and sugars and produce scalable quantities of synthetic mucins offers opportunities to develop these molecules as anti-infectives, probiotics and therapies to support reproductive and women’s health, Kramer says.

The research was funded by the National Institute of General Medical Science, National Science Foundation and Marion Milligan Mason Fund.

Visit the ACS Spring 2024 program to learn more about this presentation, “Synthetic mucins: From new chemical routes to engineered cells,” and more scientific presentations. 

###

The American Chemical Society (ACS) is a nonprofit organization chartered by the U.S. Congress. ACS’ mission is to advance the broader chemistry enterprise and its practitioners for the benefit of Earth and all its people. The Society is a global leader in promoting excellence in science education and providing access to chemistry-related information and research through its multiple research solutions, peer-reviewed journals, scientific conferences, eBooks and weekly news periodical Chemical & Engineering News. ACS journals are among the most cited, most trusted and most read within the scientific literature; however, ACS itself does not conduct chemical research. As a leader in scientific information solutions, its CAS division partners with global innovators to accelerate breakthroughs by curating, connecting and analyzing the world’s scientific knowledge. ACS’ main offices are in Washington, D.C., and Columbus, Ohio.

To automatically receive news releases from the American Chemical Society, contact newsroom@acs.org.

Note to journalists: Please report that this research was presented at a meeting of the American Chemical Society. ACS does not conduct research, but publishes and publicizes peer-reviewed scientific studies.

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Title
Synthetic mucins: From new chemical routes to engineered cells

Abstract
Mucin glycoproteins are the major component of mucus and the epithelial glycocalyx. Mucins are essential for life, serving roles as a physical barrier, a lubricant, and a biochemical moderator of infection, immunity, and cancer. There are more than 20 known mucin genes with variable expression patterns, splicing, and post-translational glycosylation patterns. Such diversity has challenged study of structure-function relationships. We are developing scalable methods, based on polymerization of amino acid N-carboxyanhydrides, to synthesize glycan-bearing polypeptides that capture the chemical and physical properties of native mucins. We are utilizing these synthetic mucins to form fully synthetic mucus hydrogels and to engineer the glycocalyx of live cells to shed light on the role of glycans in health and disease. This talk will focus on advances in chemical synthesis along with application of synthetic mucins in study of tumorigenesis.


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