Impact of N95 Mask Induced Carbon Dioxide Retention on Intraocular Pressure in Glaucoma Versus Non-Glaucoma Individuals
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Background: Prolonged N95 mask wear may alter respiratory effort and the local mask microenvironment, raising concern about possible intraocular pressure changes in individuals with glaucoma. Because glaucoma patients may be more vulnerable to pressure fluctuation, comparative evidence between glaucomatous and non-glaucomatous individuals is clinically relevant. Objective: To compare serial intraocular pressure changes during prolonged N95 mask wear in glaucomatous and non-glaucomatous adults. Methods: This quasi-experimental comparative study included 50 participants, with 25 glaucomatous and 25 non-glaucomatous individuals. Intraocular pressure was measured using Goldmann applanation tonometry before N95 mask wear and after 5 minutes, 1 hour, and 4 hours of continuous mask use. Baseline clinical characteristics and serial intraocular pressure values were compared between groups, and change from baseline was calculated. Results: The mean age was 32.58 ± 12.44 years, and 29 participants were female. Baseline intraocular pressure was higher in the glaucomatous group than in the non-glaucomatous group (19.32 ± 1.61 vs. 15.03 ± 1.58 mmHg). After 4 hours, intraocular pressure increased to 23.14 ± 1.52 mmHg in the glaucomatous group and 16.52 ± 1.70 mmHg in the non-glaucomatous group, corresponding to mean increases of 3.82 and 1.49 mmHg, respectively. Conclusion: Prolonged N95 mask wear was associated with progressive intraocular pressure elevation, with a larger increase among glaucomatous individuals. Because carbon dioxide was not directly measured, mechanism-related conclusions should remain cautious.
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