A significant increase in post-vitrectomy endophthalmitis cases warrants vigilant follow-up and patient instruction on proper mask wearing. Photo: Ani Kolleshi on Unsplash.

Masks help lower the spread of disease, but a recently published paper pointed out that the “constant circulation of air around the wearer’s eye by a mask can enhance the chance of infections leading to endophthalmitis.” This was confirmed in the retrospective study.

The multicenter study examined the incidence and causative pathogens of these endophthalmitis cases. Patients who had undergone vitrectomy pre-COVID and during the one-year mandated mask-wearing period during the COVID-19 pandemic were included. 

The researchers reported a significantly lower incidence of endophthalmitis pre-COVID compared with the mask period (0.11% vs. 0.21%). Of the pre-COVID infections, 22% were culture positive, all of the Staphylococcus family. During the mask period, almost 30% of infected eyes were culture positive, with four cases related to oral commensals such as Streptococcus spp. The researchers noted that these bacteria are rarely reported in post-vitrectomy endophthalmitis. 

The researchers concluded that the significant increase in post-vitrectomy endophthalmitis cases during the mask-wearing period warrants vigilant follow-up and patient instruction on proper mask wearing. “Although COVID-19 vaccinations are available worldwide and mask wearing has not been mandated in some areas or countries, there’s still a need for mask wearing,” the researchers wrote in their paper. “Because the need for vitreoretinal surgery will continue regardless of the presence of COVID-19, it’s important for clinicians to know the present results and treat their patients accordingly.”

Sakamoto T, Terasaki H, Yamashita T, et al. Increased incidence of endophthalmitis after vitrectomy relative to face mask wearing during COVID-19 pandemic. Br J Ophthalmol. June 20, 2002. [Epub ahead of print].