You will most likely be reading this page following your trabeculectomy surgery, where a ‘bleb’ was created in the white part of your eye under the upper eyelid.
A bleb is a trap-door that allows fluid to drain out of the eye to reduce the pressure inside the eye, which in turn helps treat your glaucoma.
Sometimes, infection can occur at the place you were operated on. There are two main types of infection, called ‘blebitis’ and ‘bleb related endopthalmitis’. Blebitis is an infection which just affects the bleb, and ‘bleb related endophthalmitis’ is when the infection spreads into the eye. This second type of infection is far more severe than blebitis and can cause blindness if not treated quickly.
If you experience any of these symptoms, please go straight to your local A&E department, or Moorfields A&E department in City Road, which is open 24/7 (for emergency eye problems only).
We strongly advise you seek medical help, as 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.
Bleb related infection is quite an uncommon condition, occurring in about one to five people out of every 100 people who have trabeculectomy surgery in a given year.
There are various factors which can cause this, which include having a bleb leak, suffering from conjunctivitis or blepharitis, wearing contact lenses, having a previous bleb related infection, having had a second operation on the bleb, using antibiotics, and having diabetes.
This depends on what type of infection you have. If you have blebitis, you will be admitted to Moorfields and given a combination of antibiotic steroid eye drops. You will also begiven antibiotics to take by mouth. If you have bleb related endophthalmitis, you will be given the same treatment, but you will also be given injections of antibiotics and a steroid into the eye, and steroid tablets to be taken by mouth.
If you suffer from dry crusty eyelid margins, blepharitis, eye infections or dry eye, these need to be treated and be kept under control with regular treatment and reviews by your ophthalmologist. We also advise you do not rub your eye or touch the bleb to reduce infection.
Common symptoms include eye pain, redness of the eye, reduced vision, pain when looking into light and discharge coming out from the eye.
If you experience any of these symptoms, please go straight to your local A&E department, or Moorfields A&E department in City Road, which is open 24/7 (for emergency eye problems only).
We strongly advise you seek medical help, as 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.
Authors: Dr Zaman Durani, honorary registrar, Miss Poornima Rai, consultant ophthalmic surgeon, glaucoma service
Review date: December 2022