The Ophthalmology Unit,  Universiti Malaysia Sarawak (UNIMAS), Kuching, Sarawak.

The Ophthalmology Department, Sarawak General Hospital, Kuching, Sarawak, East Malaysia.

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Bleb leakage

Photo by Dr. Ngo Chek Tung

A 55 year-old woman with advanced glaucoma (Right eye 6/12; C/D 0.8 and Left eye LP; C/D 1.0) underwent trabeculectomies with mitomycin C in both eyes. Post-operatively, the intraocular pressures in both eyes were reduced without anti-glaucoma treatment. However, the right eye exhibited shallow anterior chamber with an intraocular pressure of 5mmHg. The bleb showed positive Seidel sign. A soft contact lens was applied and the anterior chamber deepened. When the contact lens was removed 4 days later, the leakage recurred and the anterior chamber became shallow again within 24 hours. Resuturing of the free edge of the flap stopped the leakage and the anterior chamber reformed.

 

Shallow bleb 3 days post-trabeculectomy with mitomycin C.

 

Fluorescence applied to look for Seidel sign.

 

Leakage seen (dilution of the fluorescence) from the free edge of the bleb ie. positive Seidel sign.

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