Blebitis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
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Overview
Historical Perspective
Classification
Pathophysiology
Causes
- Blebitis may be caused by bacterial infection, predominantly Staphylococcus aureus and strains of Streptococcus.[1]
- The occular bleb's predisposition to infection occurs due to exposure and vulnerability following a trabeculectomy to treat glaucoma.[2]
- Blebitis is a rare complication of trabeculectomy.
Differentiating Blebitis from Other Diseases
Epidemiology and Demographics
Risk Factors
- Common risk factors in the development of Blebibits include the following:[3]
- Undergoing trabulectomy for glaucoma
- Experiencing a bleb-leak
- Being young
- Being African-American
- Experiencing recurrent bacterial conjunctivitis
- Inferior location of the filtering bleb
Screening
Natural History, Complications, and Prognosis
Natural History
Complications
Prognosis
Diagnosis
Diagnostic Criteria
Symptoms
- Symptoms of blebitis may include the following:[4]
- Ocular pain of the filtering bleb
- Excessive sensitivity to light[5]
- Vision loss
- Intraocular pressure
- Fluid discharge[2]
Physical Examination
- Physical examination may be remarkable for:
- Hyperaemia in the affected eye
- Erythema of the affected eye due to presence of hypopyon[4]
- Thinning of the bleb epithelium
- Whitening of the bleb[6]
Laboratory Findings
Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
- The mainstays of therapy for blebitis are fortified topical antimicrobial and antibacterial agents:[7]
- Topical corticosteroids are often used in conjunction with antimicrobrial therapy.
Surgery
Prevention
References
- ↑ Wallin Ö, Al-ahramy AM, Lundström M, Montan P (2014). "Endophthalmitis and severe blebitis following trabeculectomy. Epidemiology and risk factors; a single-centre retrospective study". Acta Ophthalmol. 92 (5): 426–31. doi:10.1111/aos.12257. PMID 24020653.
- ↑ 2.0 2.1 Matsuo H, Tomita G, Araie M, Suzuki Y, Kaji Y, Obata H, Tanaka S (2002). "Histopathological findings in filtering blebs with recurrent blebitis". Br J Ophthalmol. 86 (7): 827. PMC 1771211. PMID 12084758.
- ↑ Soltau JB, Rothman RF, Budenz DL, Greenfield DS, Feuer W, Liebmann JM, Ritch R (2000). "Risk factors for glaucoma filtering bleb infections". Arch. Ophthalmol. 118 (3): 338–42. PMID 10721955.
- ↑ 4.0 4.1 Brown, Reay H. (1994). "Treatment of Bleb Infection After Glaucoma Surgery". Archives of Ophthalmology. 112 (1): 57. doi:10.1001/archopht.1994.01090130067019. ISSN 0003-9950.
- ↑ Feldman, Robert (2013). Complications of glaucoma surgery. Oxford: Oxford University Press. ISBN 978-0-19-538236-5.
- ↑ Brown RH, Yang LH, Walker SD, Lynch MG, Martinez LA, Wilson LA (1994). "Treatment of bleb infection after glaucoma surgery". Arch. Ophthalmol. 112 (1): 57–61. PMID 8285894.
- ↑ Reynolds AC, Skuta GL, Monlux R, Johnson J (2001). "Management of blebitis by members of the American Glaucoma Society: a survey". J. Glaucoma. 10 (4): 340–7. PMID 11558820.