{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T11:39:12Z","timestamp":1753357152637,"version":"3.37.3"},"reference-count":52,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T00:00:00Z","timestamp":1668556800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002383","name":"King Saud University","doi-asserted-by":"publisher","award":["Vice Deanship of Scientific Research Chairs, Research Chair of Cornea"],"award-info":[{"award-number":["Vice Deanship of Scientific Research Chairs, Research Chair of Cornea"]}],"id":[{"id":"10.13039\/501100002383","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Purpose<\/jats:title><jats:p>Due to the COVID-19 pandemic, wearing a face mask has become an essential measure to reduce the rate of virus spreading. The aim of the study was to assess the effect of wearing a surgical face mask for a short period on the tear film parameters in subjects with a high body mass index (BMI).<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>Twenty-five females with a high BMI (31.4 \u00b1 5.5 kg\/m<jats:sup>2<\/jats:sup>) aged 18\u201335 years (22.7 \u00b1 4.6 years) participated in the study. In addition, a control group consisting of 25 females (23.0 \u00b1 6.7 years) with a high BMI (29.9 \u00b1 4.1 kg\/m<jats:sup>2<\/jats:sup>) participated in the study in which no mask was worn. The standardized patient evaluation of eye dryness (SPEED) questionnaire was completed first, followed by the phenol red thread (PRT) and tear ferning (TF) tests, before wearing the face mask. The subjects wore the face mask for 1 hour, and the measurements were performed again immediately after its removal. For the control group, the measurements were performed twice with one hour gap.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>Significant (Wilcoxon test, p &lt; 0.05) differences were found between the SPEED scores (p = 0.035) and the PRT measurement (p = 0.042), before and after wearing the surgical face mask. The PRT scores have improved after wearing the surgical face mask, while the dry eye symptoms detected by the SPEED questionnaire have increased. On the other hand, no significant (Wilcoxon test, p = 0.201) differences were found between the TF grades before and after wearing a surgical face mask. For the control group, no significant (Wilcoxon test, p &gt; 0.05) differences were found between the two scores from the SPEED questionnaire and the PRT, and TF tests.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusions<\/jats:title><jats:p>Wearing a surgical face mask for a short duration leads to a change in volume and quality of tears as well as dry eye symptoms in women with a high BMI.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0277803","type":"journal-article","created":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T18:35:15Z","timestamp":1668623715000},"page":"e0277803","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effect of surgical face mask wearing on tear film in women with a high body mass index"],"prefix":"10.1371","volume":"17","author":[{"given":"Mana A.","family":"Alanazi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6675-3126","authenticated-orcid":true,"given":"Gamal A.","family":"El-Hiti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reem","family":"Alotaibi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mashaaer A.","family":"Baashen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2994-1472","authenticated-orcid":true,"given":"Muteb","family":"Alanazi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6255-4549","authenticated-orcid":true,"given":"Raied","family":"Fagehi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali M.","family":"Masmali","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,11,16]]},"reference":[{"key":"pone.0277803.ref001","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.jtos.2014.02.002","article-title":"Rethinking dry eye disease: a perspective on clinical implications","volume":"12","author":"AJ Bron","year":"2014","journal-title":"Ocul Surf"},{"key":"pone.0277803.ref002","doi-asserted-by":"crossref","first-page":"781683","DOI":"10.1155\/2014\/781683","article-title":"Aging: a predisposition to dry eyes","volume":"2014","author":"A Sharma","year":"2014","journal-title":"J Ophthalmol"},{"key":"pone.0277803.ref003","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1097\/IIO.0000000000000170","article-title":"Effects of aging in dry eye","volume":"57","author":"CS de Paiva","year":"2017","journal-title":"Int Ophthalmol Clin"},{"key":"pone.0277803.ref004","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1016\/j.ajo.2008.05.016","article-title":"Advances in understanding and managing dry eye disease","volume":"146","author":"MA Lemp","year":"2008","journal-title":"Am J Ophthalmol"},{"key":"pone.0277803.ref005","first-page":"704946","article-title":"A comprehensive review on dry eye disease: diagnosis, medical management, recent developments, and future challenges","volume":"2015","author":"SP Phadatare","year":"2015","journal-title":"Adv Pharm"},{"key":"pone.0277803.ref006","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1016\/j.exer.2003.09.003","article-title":"The role of the lacrimal functional unit in the pathophysiology of dry eye","volume":"78","author":"ME Stern","year":"2004","journal-title":"Exp Eye Res"},{"key":"pone.0277803.ref007","first-page":"176","article-title":"Immune response and the eye","volume":"92","author":"JY Niederkorn","year":"2007","journal-title":"Chem Immunol Allergy"},{"key":"pone.0277803.ref008","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1016\/j.preteyeres.2004.04.003","article-title":"Changes in the tear film and ocular surface from dry eye syndrome","volume":"23","author":"ME Johnson","year":"2004","journal-title":"Prog Retin Eye Res"},{"key":"pone.0277803.ref009","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1016\/j.ophtha.2012.06.064","article-title":"Improving awareness, identification, and management of meibomian gland dysfunction","volume":"119","author":"GN Foulks","year":"2012","journal-title":"Ophthalmology"},{"key":"pone.0277803.ref010","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/S0002-9394(03)00203-4","article-title":"Abnormal protein profiles in tears with dry eye syndrome","volume":"136","author":"Y Ohashi","year":"2003","journal-title":"Am J Ophthalmol"},{"key":"pone.0277803.ref011","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1159\/000131069","article-title":"Classification and diagnosis of dry eye. In: Surgery for the Dry Eye","volume":"41","author":"T Kaercher","year":"2008","journal-title":"Developments in Ophthalmology"},{"key":"pone.0277803.ref012","first-page":"1050","article-title":"Comparison of the OSDI and SPEED questionnaires for the evaluation of dry eye disease in clinical routine","volume":"111","author":"D Finis","year":"2014","journal-title":"Ophthalmologe"},{"key":"pone.0277803.ref013","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1097\/00006324-200103000-00005","article-title":"What does the phenol red thread test actually measure?","volume":"78","author":"A Tomlinson","year":"2001","journal-title":"Optom Vis Sci"},{"key":"pone.0277803.ref014","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.cyto.2018.02.009","article-title":"Effect of tear supplements on signs, symptoms and inflammatory markers in dry eye","volume":"105","author":"E Martin","year":"2018","journal-title":"Cytokine"},{"key":"pone.0277803.ref015","doi-asserted-by":"crossref","first-page":"168","DOI":"10.4103\/tjo.tjo_65_20","article-title":"Investigation of the repeatability of tear osmolarity using an I-PEN osmolarity device","volume":"11","author":"R Fagehi","year":"2021","journal-title":"Taiwan J Ophthalmol"},{"key":"pone.0277803.ref016","doi-asserted-by":"crossref","first-page":"405","DOI":"10.3390\/healthcare10020405","article-title":"Measurements of tear evaporation rate in subjects with refractive errors using a portable evaporimeter","volume":"10","author":"R Fagehi","year":"2022","journal-title":"Healthcare"},{"key":"pone.0277803.ref017","doi-asserted-by":"crossref","first-page":"605","DOI":"10.2147\/OPTH.S201127","article-title":"The acute effect of a single dose of green tea on the quality and quantity of tears in normal eye subjects","volume":"13","author":"AM Masmali","year":"2019","journal-title":"Clin Ophthalmol"},{"key":"pone.0277803.ref018","first-page":"108","article-title":"Methodologies to diagnose and monitor dry eye disease: report of the Diagnostic Methodology Subcommittee of the Inter-national Dry Eye Workshop (2007).","volume":"5","journal-title":"The Ocul Surf 2007"},{"key":"pone.0277803.ref019","first-page":"CD009729","article-title":"Over the counter (OTC) artificial tear drops for dry eye syndrome","volume":"2","author":"AD Pucker","year":"2016","journal-title":"Cochrane Database Syst. Rev"},{"key":"pone.0277803.ref020","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1097\/01.ico.0000176611.88579.0a","article-title":"Efficacy of commercially available topical cyclosporine A 0.05% in the treatment of meibomian gland dysfunction","volume":"25","author":"HD Perry","year":"2006","journal-title":"Cornea"},{"key":"pone.0277803.ref021","first-page":"497","volume-title":"In Comparative Quantification of Health Risks Global and Regional Burden of Disease Attributable to Selected Major Risk Factors","author":"World Health Organization","year":"2004"},{"key":"pone.0277803.ref022","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/S0140-6736(03)15268-3","article-title":"Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies","volume":"363","year":"2004","journal-title":"Lancet"},{"key":"pone.0277803.ref023","doi-asserted-by":"crossref","first-page":"77","DOI":"10.2147\/OPTO.S218109","article-title":"Assessment of tear film in subjects with a high body mass index","volume":"11","author":"SA Alanazi","year":"2019","journal-title":"Clin Optom"},{"key":"pone.0277803.ref024","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1001\/jama.2021.1505","article-title":"Effectiveness of mask wearing to control community spread of SARS-CoV-2","volume":"325","author":"JT Brooks","year":"2021","journal-title":"JAMA"},{"key":"pone.0277803.ref025","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1097\/ICL.0000000000000288","article-title":"Rasch analysis of the standard patient evaluation of eye dryness questionnaire","volume":"43","author":"K. Asiedu","year":"2017","journal-title":"Eye Contact Lens"},{"key":"pone.0277803.ref026","doi-asserted-by":"crossref","first-page":"1204","DOI":"10.1097\/ICO.0b013e318294b0c0","article-title":"Psychometric properties and validation of the standard patient evaluation of eye dryness questionnaire","volume":"32","author":"W Ngo","year":"2013","journal-title":"Cornea"},{"key":"pone.0277803.ref027","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1097\/ICL.0000000000000025","article-title":"Comparative study of repeatability of phenol red thread test versus Schirmer\u2019s test in normal adults in Saudi Arabia","volume":"40","author":"A Masmali","year":"2014","journal-title":"Eye Contact Lens"},{"key":"pone.0277803.ref028","doi-asserted-by":"crossref","first-page":"9524143","DOI":"10.1155\/2021\/9524143","article-title":"Analysis of tear ferning patterns in young female subjects with refractive errors","volume":"2021","author":"MA Alanazi","year":"2021","journal-title":"J. Ophthalmol"},{"key":"pone.0277803.ref029","doi-asserted-by":"crossref","first-page":"S70","DOI":"10.1097\/ICL.0000000000000419","article-title":"Investigation of ocular tear ferning in controlled and uncontrolled diabetic subjects","volume":"44","author":"AM Masmali","year":"2018","journal-title":"Eye Contact Lens"},{"key":"pone.0277803.ref030","doi-asserted-by":"crossref","first-page":"8154315","DOI":"10.1155\/2016\/8154315","article-title":"Assessment of tear film quality among smokers using tear ferning patterns","volume":"2016","author":"AM Masmali","year":"2016","journal-title":"J Ophthalmol"},{"key":"pone.0277803.ref031","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.clae.2014.09.007","article-title":"Application of a new grading scale for tear ferning in non-dry eye and dry eye subjects","volume":"38","author":"AM Masmali","year":"2015","journal-title":"Cont Lens Anterior Eye"},{"author":"A Masmali","key":"pone.0277803.ref032","article-title":"Repeatability and diurnal variation of tear"},{"key":"pone.0277803.ref033","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"J. Cohen","year":"1988","edition":"2"},{"key":"pone.0277803.ref034","doi-asserted-by":"crossref","first-page":"e199","DOI":"10.1097\/OPX.0000000000000541","article-title":"Risk factors for dry eye syndrome: a retrospective case-control study","volume":"92","author":"W-J Yang","year":"2015","journal-title":"Optom Vis Sci"},{"key":"pone.0277803.ref035","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1016\/j.ajo.2014.08.021","article-title":"Prevalence of and risk factors associated with dry eye: the Korea National Health and Nutrition Examination Survey 2010\u20132011","volume":"158","author":"JM Ahn","year":"2014","journal-title":"Am J Ophthalmol"},{"key":"pone.0277803.ref036","doi-asserted-by":"crossref","first-page":"e429","DOI":"10.1111\/aos.12174","article-title":"al. Dry eye disease in French elderly subjects: the Alienor Study","volume":"92","author":"F Malet","year":"2014","journal-title":"Acta Ophthalmol"},{"key":"pone.0277803.ref037","doi-asserted-by":"crossref","first-page":"2361","DOI":"10.1016\/j.ophtha.2011.05.029","article-title":"Prevalence and risk factors of dry eye disease in Japan: Koumi study","volume":"118","author":"M Uchino","year":"2011","journal-title":"Ophthalmology"},{"key":"pone.0277803.ref038","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1097\/ICL.0000000000000275","article-title":"A possible association between dry eye symptoms and body fat: a prospective, cross-sectional preliminary study","volume":"43","author":"KC Ho","year":"2017","journal-title":"Eye Contact Lens"},{"key":"pone.0277803.ref039","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1097\/ICL.0000000000000814","article-title":"Relation between body mass index and dry eye disease: The Japan Public Health Center-Based prospective study for the next generation","volume":"47","author":"R Yamanishi","year":"2021","journal-title":"Eye Contact Lens"},{"key":"pone.0277803.ref040","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1007\/s40123-020-00282-6","article-title":"Face mask-associated ocular irritation and dryness","volume":"9","author":"M Moshirfar","year":"2020","journal-title":"Ophthalmol Ther"},{"key":"pone.0277803.ref041","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1080\/13102818.2020.1838323","article-title":"Ophthalmic complaints in face-mask wearing: prevalence, treatment, and prevention with a potential protective effect against SARS-CoV-2","volume":"34","author":"E Marinova","year":"2020","journal-title":"Biotechnol Biotechnol Equip"},{"key":"pone.0277803.ref042","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1097\/ICO.0000000000002734","article-title":"Effect of face mask on tear film stability in eyes with moderate-to-severe dry eye disease","volume":"40","author":"P Arriola-Villalobos","year":"2021","journal-title":"Cornea"},{"key":"pone.0277803.ref043","article-title":"Effect of facemasks on the tear film during the COVID-19 pandemic","author":"HS Shalaby","year":"2022","journal-title":"Eur J Ophthalmol"},{"key":"pone.0277803.ref044","doi-asserted-by":"crossref","first-page":"2141","DOI":"10.1007\/s10792-022-02213-9","article-title":"Impact of prolonged face mask wearing on tear break-up time and dry eye symptoms in health care professionals","volume":"42","author":"M Esen Baris","year":"2022","journal-title":"Int Ophthalmol"},{"key":"pone.0277803.ref045","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1001\/jamaophthalmol.2020.1291","article-title":"Characteristics of ocular findings of patients with coronavirus disease 2019 (COVID-19) in Hubei Province, China","volume":"138","author":"P Wu","year":"2020","journal-title":"JAMA Ophthalmol"},{"key":"pone.0277803.ref046","doi-asserted-by":"crossref","first-page":"155","DOI":"10.3389\/fpubh.2020.00155","article-title":"Role of the eye in transmitting human coronavirus: what we know and what we do not know","volume":"8","author":"C Sun","year":"2020","journal-title":"Front in Public Health"},{"key":"pone.0277803.ref047","doi-asserted-by":"crossref","first-page":"102612","DOI":"10.1016\/j.amjoto.2020.102612","article-title":"Symptomatology in head and neck district in coronavirus disease (COVID-19): a possible neuroinvasive action of SARS-CoV-2","volume":"41","author":"F Freni","year":"2020","journal-title":"Am J Otolaryngol"},{"key":"pone.0277803.ref048","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1177\/11206721211002442","article-title":"Effect of COVID-19-related lockdown on ophthalmic practice in Italy: A report from 39 institutional centers","volume":"32","author":"R. dell\u2019Omo","year":"2022","journal-title":"Eur J Ophthalmol"},{"key":"pone.0277803.ref049","doi-asserted-by":"crossref","first-page":"20178","DOI":"10.1038\/s41598-020-77194-9","article-title":"Ocular surface manifestation of COVID-19 and tear film analysis","volume":"10","author":"A Meduri","year":"2020","journal-title":"Sci Rep"},{"key":"pone.0277803.ref050","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.survophthal.2007.04.009","article-title":"The correlation between the tear film lipid layer and dry eye disease","volume":"52","author":"GN Foulks","year":"2007","journal-title":"Surv Ophthalmol"},{"key":"pone.0277803.ref051","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1001\/archopht.118.9.1264","article-title":"Prevalence of and risk factors for dry eye syndrome","volume":"118","author":"SE Moss","year":"2000","journal-title":"Arch Ophthalmol"},{"key":"pone.0277803.ref052","doi-asserted-by":"crossref","first-page":"258","DOI":"10.1111\/j.1600-0668.2006.00429.x","article-title":"The modern office environment desiccates the eyes?","volume":"16","author":"P Wolkoff","year":"2006","journal-title":"Indoor Air"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0277803","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T00:07:52Z","timestamp":1701389272000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0277803"}},"subtitle":[],"editor":[{"given":"Alon","family":"Harris","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2022,11,16]]},"references-count":52,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,11,16]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0277803","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2022,11,16]]}}}