Blebitis is an infection involving a prior filtering bleb and it is a serious, sight-threatening complication demanding immediate, aggressive management because it can quickly evolve into full-blown endophthalmitis with catastrophic damage to the eye. While mild, localized cases may respond to intensive topical and systemic antibiotics, but the presence of frank bleb leak, hypotony, or progression to endophthalmitis mandates surgical intervention. The primary surgical goal is to eradicate the infectious nidus and restore ocular integrity. This often involves bleb debridement or, as in this case, complete excision. The infected, necrotic tissue is meticulously removed, and the underlying scleral ostium may be closed or patched using a donor patch graft or scleral flap to prevent further ingress of pathogens and restore the anterior chamber. If endophthalmitis is confirmed or suspected, an urgent pars plana vitrectomy with vitreous biopsy and intraocular antibiotic injection is performed. Aggressive, timely surgery is critical to maximize the visual prognosis. Remember that CataractCoach is your number 1 source for everything surgical of the anterior segment: cataract, glaucoma, cornea, and refractive and we are always looking for more videos/content to create the world’s largest surgical video library for this field.
