Incidence of hordeola and chalazia during the COVID-19 pandemic: the role of mask wear

Clinical RelevanceUnderstanding the associations between mask wear and hordeola and chalazia formation are important for eyecare physicians as they may be overlooked as a direct cause. The literature on these possible relationships is limited.BackgroundThe intention of this study was to determine if there was an increased incidence of internal/external hordeola and chalazia secondary to the implementation of mask wear due to the COVID-19 pandemic in an academic clinical setting.MethodsA retrospective chart review of electronic medical records at the Illinois Eye Institute was conducted. Cases were categorised into two groups: pre-COVID/pre- mask wear (December 2018-February 2020) and during the pandemic/mask wear (May 2020-July 2022). Demographic data were also compared between the two groups.ResultsA total of 163 cases of hordeola and chalazia were reported pre-COVID, with an increase to 225 during the pandemic/mask wear period. Due to the reduction in patient visits because of COVID restrictions, an incidence analysis was conducted to determine occurrence rates per 1000 visits. The pre-COVID period showed a total incidence rate of 3.06 cases per 1000 patients (hordeola 1.6/chalazia 1.57) while during the mask wearing period the incidence rate increased to 6.32 cases per 1000 patients (hordeola 2.5/chalazions 3.82). A total incidence rate ratio was calculated to be 2.1 (hordeola 1.6/chalazia 2.6) correlating to a greater chance of developing the conditions during mask wear.ConclusionsAn increase in the incidence of chalazia and hordeola were noted in the mask wear/pandemic group when compared to the pre-mask wear group. Increased mask wear may be a principal cause of hordeola and chalazia.