Treatment of bleb infection after glaucoma surgery

Arch Ophthalmol. 1994 Jan;112(1):57-61. doi: 10.1001/archopht.1994.01090130067019.


Objective: To assess the history, clinical course, and response to treatment of 14 patients with a bleb infection (blebitis) following glaucoma surgery.

Design: Retrospective study.

Setting: A university referral center in Atlanta, Ga.

Patients: Fourteen patients developed a bleb infection that ranged from 1 month to 22 years after glaucoma surgery. Infections were characterized by pain, a whitened bleb surrounded by intense conjunctival injection, marked anterior chamber reaction (hypopyon in six eyes), and a clear vitreous. Before infection, most blebs were described as thin. The results of Seidel's test were positive in six patients, and most patients had a low intraocular pressure without the use of any glaucoma medication.

Intervention: Treatment consisted of hospitalization, intravenous antibiotic therapy, and hourly topical fortified cefazolin sodium and gentamicin sulfate.

Results: The visual acuity in most patients improved to the level before the bleb infection, with only three eyes losing 2 or more lines of vision.

Conclusions: Bleb infection without vitreous involvement (blebitis) may be a precursor of endophthalmitis. With aggressive treatment, bleb infection appears to have a much better prognosis for visual recovery than endophthalmitis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Cefazolin / administration & dosage
  • Cefazolin / therapeutic use
  • Drug Therapy, Combination
  • Eye Infections, Bacterial / drug therapy*
  • Eye Infections, Bacterial / etiology
  • Female
  • Gentamicins / administration & dosage
  • Gentamicins / therapeutic use
  • Glaucoma / surgery*
  • Humans
  • Injections, Intravenous
  • Male
  • Middle Aged
  • Ophthalmic Solutions
  • Retrospective Studies
  • Sclerostomy / adverse effects
  • Surgical Wound Infection / drug therapy*
  • Surgical Wound Infection / etiology
  • Trabeculectomy / adverse effects


  • Gentamicins
  • Ophthalmic Solutions
  • Cefazolin