Management of blebitis in the United Kingdom: a survey.

Abstract

To investigate the current management trend in blebitis among glaucoma consultants registered with the Royal College of Ophthalmologists (London). An anonymous survey consisting of 13 questions to ascertain blebitis management was posted to the glaucoma consultants. A χ(2) test was used to analyse the correlation patterns among respondents' answers to the questionnaire. Out of 112 questionnaires, 68 (61%) were returned. Fifty-five per cent of the consultants admit blebitis patients into hospital for treatment. Seventy-four per cent obtain a conjunctival swab, and 28% instil iodine on the conjunctiva as part of their treatment regime. Thirty-four per cent use topical fluroquinolone monotherapy, 28% cefuroxime and gentamicin, 18% fluroquinolone with cefuroxime, and 9% ceftazidime and vancomycin. Fluroquinolones are the only oral antibiotics used by those who routinely prescribe oral treatment (69%). One-fifth of respondents use intravitreal antibiotic in treating blebitis patients. Eighty-two per cent surveyed include topical corticosteroids as part of their treatment regime. Ninety-one per cent use a topical cycloplegic. Twenty-three per cent of the respondents treat blebitis as endophthalmitis, even without or with only mild anterior chamber (AC) activity. Thirty-eight per cent would do so if there was moderate AC activity, and 34% if there was severe AC activity including a hypopyon. A wide variation exists in the management of blebitis among glaucoma consultants. A standard treatment regime does not exist at the moment. Further research is needed to ascertain effective strategies to manage this condition.