• Written By:
    Comprehensive Ophthalmology, Retina/Vitreous

    Review of: The impact of physician face mask use on endophthalmitis after intravitreal anti-vascular endothelial growth factor injections

    Patel S, Hsu J, Sivalingam M, et al. American Journal of Ophthalmology, in press

    This retrospective, comparative cohort study evaluated the effect of physician face mask while administering anti-VEGF injections on rates of endophthalmitis.

    Study design

    The study included 483,622 intravitreal injections administered over a 74-month period that were separated based on whether the physician wore a mask during the injection or not (30,162 vs. 453,460). Rates of endophthalmitis and the microbial spectrum of causative organisms were compared between the 2 groups.


    Physician face mask use did not significantly affect the rate of endophthalmitis. However, there were no cases of endophthalmitis secondary to oral flora organisms in the face mask group compared with 16 cases in the no-face-mask group. Of the cases sent for culture, 5 out 7 (71%) endophthalmitis cases in the face mask group and 47 out of 119 (39%) cases in the no-face-mask group were culture positive.


    This study was retrospective and not balanced: there was more than 15 times as many injections in the no-face-mask group than the face mask group. There were also large differences in culture positivity for the endophthalmitis cases in each group, which makes interpreting the differences in flora between groups difficult.

    Clinical significance

    This study is of interest during this pandemic. Since physician mask use is universal due to COVID-19 precautions, we may be able to obtain more data about how physician mask use during anti-VEGF injections affects rate of endophthalmitis.