The effect of eye protection on SARS-CoV-2 transmission: a systematic review

Antimicrob Resist Infect Control. 2021 Nov 4;10(1):156. doi: 10.1186/s13756-021-01025-3.


Background: The effect of eye protection to prevent SARS-CoV-2 infection in the real-world remains uncertain. We aimed to synthesize all available research on the potential impact of eye protection on transmission of SARS-CoV-2.

Methods: We searched PROSPERO, PubMed, Embase, The Cochrane Library for clinical trials and comparative observational studies in CENTRAL, and Europe PMC for pre-prints. We included studies that reported sufficient data to estimate the effect of any form of eye protection including face shields and variants, goggles, and glasses, on subsequent confirmed infection with SARS-CoV-2.

Results: We screened 898 articles and included 6 reports of 5 observational studies from 4 countries (USA, India, Columbia, and United Kingdom) that tested face shields, goggles, and wraparound eyewear on 7567 healthcare workers. The three before-and-after and one retrospective cohort studies showed statistically significant and substantial reductions in SARS-CoV-2 infections favouring eye protection with odds ratios ranging from 0.04 to 0.6, corresponding to relative risk reductions of 96% to 40%. These reductions were not explained by changes in the community rates. However, the one case-control study reported odds ratio favouring no eye protection (OR 1.7, 95% CI 0.99, 3.0). The high heterogeneity between studies precluded any meaningful meta-analysis. None of the studies adjusted for potential confounders such as other protective behaviours, thus increasing the risk of bias, and decreasing the certainty of evidence to very low.

Conclusions: Current studies suggest that eye protection may play a role in prevention of SARS-CoV-2 infection in healthcare workers. However, robust comparative trials are needed to clearly determine effectiveness of eye protections and wearability issues in both healthcare and general populations.

Keywords: COVID-19; Eye protection; Face shield; Infection prevention; SARS-CoV-2.

Publication types

  • Systematic Review

MeSH terms

  • COVID-19 / prevention & control*
  • COVID-19 / transmission
  • Communicable Disease Control
  • Eye Protective Devices*
  • Humans
  • Infectious Disease Transmission, Professional-to-Patient / prevention & control*
  • Pandemics / prevention & control*
  • SARS-CoV-2