What are the other Names for this Condition? (Also known as/Synonyms)

• Bleb Infection
• Infection of the Bleb

What is Blebitis? (Definition/Background Information)

• Trabeculectomy is a surgical procedure for treating glaucoma. In this procedure, a tiny hole is created on the conjunctiva (eye surface) to drain fluid from inside the eye, in order to regulate eye pressure. This tiny hole, placed behind the upper eyelid, is known as the “bleb”
• Blebitis is a rare infection of the bleb occurring within a few months to even a few years after glaucoma filtration surgery (trabeculectomy). This post-operative complication is classified as early-onset or late-onset, and is a form of bleb-related infection
• Prompt recognition and aggressive treatment of Blebitis is warranted to prevent progression of the condition to endophthalmitis and irreversible vision loss. With early treatment, the outcomes are improved

Who gets Blebitis? (Age and Sex Distribution)

• Blebitis is rare and is only observed in individuals who have undergone eye surgery (trabeculectomy) for glaucoma
• Both males and females may be affected
• Worldwide, individuals of all races and ethnicity are prone to developing the condition

What are the Risk Factors for Blebitis? (Predisposing Factors)

The risk factors for Blebitis may include:

• Young age of the individual
• Bleb leaks: It may occur immediately following surgery (within 3 months), or after a certain period of time. According to medical literature, the risk for Blebitis increases 26-fold with bleb leakage
• Administration of antifibrotic/antimetabolite agents (5-fluorouracil and mitomycin-C), either during or after surgery
• Improper location of the bleb
• Shortsightedness
• Inflammation of the eyelids (blepharitis)
• Infection of the conjunctiva (conjunctivitis)
• Upper respiratory infections
• Some reports indicate a higher risk during winter seasons
• Uncontrolled diabetes
• Individuals with weak immune systems

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Blebitis? (Etiology)

Blebitis is an infection that develops secondary to trabeculectomy surgery to treat glaucoma. The most common microorganisms causing infection are Staphylococcus aureus and Staphylococcus epidermidis (bacteria).

• The factors that may increase the risk for infection include the surgical approach, intraoperative and postoperative treatments, and other complications such as bleb leakage
• A host of other contributory factors have been reported for Blebitis, such as eye and upper respiratory infections, diabetes, and poor immunity

What are the Signs and Symptoms of Blebitis?

The signs and symptoms of Blebitis may include:

• Eye pain with acute onset
• Eye redness and tearing
• Eye irritation
• Blurred vision
• Sensitivity to light
• Discharge from the eye
• Decreased vision
• Sensation of foreign body in the eye
• Decreased intraocular pressure or hypotony

How is Blebitis Diagnosed?

Blebitis may be diagnosed by the following observations and tests:

• Physical examination and medical history evaluation (including history of eye surgery for glaucoma)
• Assessment of the signs and symptoms
• General eye exam to check for post-surgical complications
• Fundoscopic (ophthalmoscopic) examination by an eye specialist, who examines the back part of the eye (or the fundus)
• Visual acuity test using a special and standardized test chart (Snellen chart)
• Slit-lamp examination
• Culture of eye scrapings to determine presence of the bacteria
• Slit-lamp examination
• B-scan ocular ultrasonography and ultrasound biomicroscopy (UBM)

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Blebitis?

The complications of Blebitis may be severe and include:

• Severe infection involving other eye structures
• Progression into more severe eye disease known as bleb-associated endophthalmitis
• Permanent blindness
• Complications from treatment of the infection
• Decreased quality of life

How is Blebitis Treated?

The treatment for Blebitis may involve the following measures:

• Administration of antibiotics through topical applications and eye drops
• Cycloplegics, based on healthcare provider’s assessment
• Use of topical steroids
• Hospitalization is necessary for severe cases, with intravenous administration of antibiotics

Regular (daily) follow-up visits as advised by the eye expert/ophthalmologist.

How can Blebitis be Prevented?

Currently, there are no preventive measures for Blebitis. But an early recognition and treatment of this potential complication will help prevent vision loss.

• Individuals with certain pre-surgical eye conditions may need to be made aware of surgical risks and complications
• Healthcare providers are informed to adhere to best medical practices while performing glaucoma filtration surgeries
• Undertake prompt treatment of any eye conditions and other infections
• Seek treatment for underlying medical conditions that may reduce immunity
• In general, follow good hygiene practices

Close follow-up is recommended to evaluate treatment response and prevent any further post-surgical complications.

What is the Prognosis of Blebitis? (Outcomes/Resolutions)

• The prognosis for Blebitis is mostly good, since the condition is treatable with early diagnosis and appropriate treatment (which is extremely important)
• However, a delayed diagnosis and/or treatment may adversely affect outcomes. In some cases, it may progress to severe infections and result in irreversible eye damage including complete vision loss

Additional and Relevant Useful Information for Blebitis:

Please visit our Eye & Vision Health Center for more physician-approved health information:

https://www.dovemed.com/health-topics/vision-center/