The shouting surgeon as a possible source of endophthalmitis.

An ophthalmic surgeon's speaking to a patient during surgery, especially if the patient is hard of hearing and the surgeon must shout to be understood, may increase the patient's risk of developing postoperative endophthalmitis. We performed an experiment demonstrating that the number of bacterial colonies on blood agar plates placed 30 cm from a person's mouth increased in relationship to the volume at which the person spoke. Wearing a surgical mask with an overlapping hood considerably reduced the levels of bacterial growth.