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Mask associated Dry Eye (MADE) during the Covid-19 pandemic

Volume 10, Issue 1

Review Article / Published: July 2022


Т. Kirova, A. Kalaydzhiev, L. Voynov

Clinic of Ophthalmology, Department of Ophthalmology, Otorhinolaryngology and Oral Surgery, Military Medical Academy, Sofia


The widespread use of protective masks in the COVID-19 era has led to an increased incidence of dry eye syndrome. In connection with this, a new disease unit emerged, called the “mask-associated dry eye” (MADE). The term was first used in June 2020. by American ophthalmologist Darrell E. White. There is a simple physical mechanism involved in the pathogenesis of mask-associated dry eye. When the protective mask is not placed correctly, the exhaled air is directed in the form of an air jet to the eye surface, creating conditions for the destabilization of the tear film. As a result, irritation and discomfort occur, and patients with MADE begin to rub their eyes frequently for temporary relief, increasing the chance of contracting the Sars CoV-2 virus. MADE may aggravate symptoms in patients with pre-existing dry eye syndrome, postmenopausal dry eye syndrome in women, and people using smart devices for more than 2 hours a day, and lead to more severe discomfort in patients after cataract or refractive surgery.


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MADE, protective masks, COVID-19

How to cite this article:

Kirova Т, Kalaydzhiev A, Voynov L. Mask associated Dry Eye (MADE) during Covid-19 pandemic. Journal of Endourology and Minimally Invasive Surgery (Bulgaria), 2022; 10(1):11-14

Corresponding author:

Dr.Tanislava Kirova,

Clinic of ophthalmology; Military Medical Academy

Аддресс: Blvd“ Georgi Sofiiski” 6 ; Sofia-1000, Bulgaria