What is a bleb related infection?

When you have trabeculectomy surgery a ‘bleb’ is created in the white part of your eye under the upper eyelid.

It is a trap-door that allows fluid to drain out of the eye to reduce the pressure inside the eye, which helps treat your glaucoma. Infection can occur at the site of the operation.

bleb needling

There are two main types of infection, called ‘blebitis’ and ‘bleb related endopthalmitis’. Blebitis is when the infection is confined to the bleb, and ‘bleb related endophthalmitis’ is when this infection spreads into the eye – it is far more severe and can cause blindness if not treated promptly.

How common are these infections?

Bleb related infection is fortunately an uncommon condition, occurring in about one to five people out of every 100 people who have trabeculectomy surgery in a given year.

What are the symptoms?
  • eye pain,
  • redness of the eye
  • reduced vision
  • pain on looking into light
  • discharge from the eye.
What do I do if I have any of these syptoms?

Call us immediately or attend your nearest eye casualty immediately!

What happens if I don’t seek medical help?

Bleb related endophthalmitis can cause the eye to go irreversibly blind in a short period of time. In the long term, infection can cause failure of the glaucoma surgery.

What are the causes for getting a bleb related infection?

Having a bleb leak, suffering from conjunctivitis or dry crusty eyelid margins (blepharitis), having had a previous bleb related infection, wearing of contact lenses, having had a second operation on the bleb, the use of antibiotics, and having diabetes.

What is the treatment?

This depends on what type of infection you have. If you have blebitis, you will be admitted to the hospital and given a combination of antibiotic steroid eye drops. You will also be given antibiotics to take by mouth. If you have a bleb related endophthalmitis you will be given the same treatment, but also be given injections of antibiotics and a steroid into the eye, and steroid tablets to be taken by mouth.

How can I prevent myself from getting a bleb related infection?

If you suffer from dry crusty eyelid margins, eye infections or dry eye, these need to be treated and be kept under control with regular treatment and reviews. Do not rub your eye or touch the bleb.