Bleb-related endophthalmitis during an epidemic of viral keratoconjunctivitis

There is an annual epidemic of viral conjunctivitis at the onset of the monsoon (rainy) season in North India. This affects a large population, with many patients developing ocular symptoms and then getting better without any treatment as there is no specific therapy for adenoviral infections. However, this creates a dangerous situation for patients with operated trabeculectomy with a filtering bleb as conjunctivitis can lead to blebitis and bleb-related endophthalmitis with super-added bacterial/fungal infections. While the viral infection is self-limiting and most patients get well without treatment, urgent medical attention is required if patients with operated trabeculectomy develop this condition. It is important to educate all patients with operated glaucoma about the outbreak of conjunctivitis and explain the danger signs (like redness, sensitivity to light, vision decrease and pain, which require immediate medical attention and initiation of broad-spectrum antibiotics if a delay is anticipated in visiting the hospital.