Management of blebitis by members of the American Glaucoma Society: a survey.
OBJECTIVE
To investigate the practice patterns among glaucoma subspecialists in the American Glaucoma Society regarding the management of blebitis.


METHODS
An anonymous survey incorporating 14 questions regarding the management of blebitis was mailed to all current active American Glaucoma Society members, including provisional members, in October 1999.


RESULTS
A total of 319 physicians received the survey, and 204 members (64%) returned surveys. Sixty-nine percent of respondents do not ask their patients with functioning blebs to use topical antibiotics at home for early symptoms of blebitis. Thirty-four percent never or almost never obtain conjunctival cultures at the onset of isolated blebitis, whereas 44% always or usually do. Fifty-one percent prescribe a topical fluoroquinolone alone as the initial empirical treatment of isolated blebitis. Twenty-three percent use a fluoroquinolone in combination with one or two other antibiotics. Twenty-one percent choose a combination of fortified topical agents, usually including a fortified aminoglycoside, vancomycin, or cephalosporin. Thirty-one percent use fortified agents in some combination with or without a fluoroquinolone. Five percent prescribe some other single agent alone. Only 6% routinely use an oral antibiotic in cases of blebitis. Sixty-two percent use topical corticosteroids in conjunction with antibiotic treatment. Of these, 68% start them after initial antibiotic treatment is established or once improvement of blebitis is noted. Fifty-six percent indicated that a moderate or severe anterior chamber reaction, including fibrin, would prompt treatment as a possible endophthalmitis. In a persistently Seidel-positive bleb, 77% generally attempt surgical bleb revision.


CONCLUSIONS
Methods of the management of blebitis differ among members of the American Glaucoma Society. Treatment recommendations generated from randomized clinical trials are needed.
Reynolds
A C
AC
The Dean A. McGee Eye Institute, University of Oklahoma College of Medicine, Oklahoma City 73104, USA.
Skuta
G L
GL
Monlux
R
R
Johnson
J
J
D000890:Anti-Infective Agents / Q000627:therapeutic use; D003625:Data Collection; D004363:Drug Utilization / Q000706:statistics & numerical data*; D015818:Eye Infections, Bacterial / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D009885:Ophthalmology / Q000706:statistics & numerical data* / Q000639:trends; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data* / Q000639:trends; D012955:Societies, Medical / Q000706:statistics & numerical data / Q000639:trends; D013530:Surgical Wound Infection / Q000188:drug therapy* / Q000382:microbiology; D011795:Surveys and Questionnaires; D014130:Trabeculectomy; D014481:United States; D014606:Uveitis, Anterior / Q000188:drug therapy* / Q000382:microbiology
D000890:Anti-Infective Agents