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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11016
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I had a trabeculectomy in the left eye on 10/3/11. I have a

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I had a trabeculectomy in the left eye on 10/3/11. I have a fluid bubble that is very uncomfortable that is on my lower eye. My pressures are running 13-15 in that eye since the surgery. Will this bubble go away?

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

Are you available to chat?

Customer:

Yes

Customer:

Sorry for the delay. My password XXXXX working and I didn't realize that you had responded.

Dr. Rick :

that's ok

Customer:

I'm still online

Dr. Rick :

If you gently raise your upper lid can you see if this bubble on the lower part of your eye is also under your upper lid?

Customer:

I was afraid you would ask that-my doctor said that the bubble was supposed to be under my lid but didnt say if there was one there as well when he looked-I'm a little uncomfortable to look myself-afraid that I will hurt myself or something

Dr. Rick :

Are you alone right now or could someone look for you?

Customer:

I don't have anyone here to look for me but can probably summon up the courage to look-I'll go do that

Dr. Rick :

ok. I'll standby

Customer:

I can't see well enough without my glasses but can get my husband to look later

Dr. Rick :

That is ok. I don't really think we need to wait.

Customer:

all right

Dr. Rick :

There is a 99.997% chance that what you are seeing is the normal results of a trabeculectomy surgery.....that is the formation of what is called a "filtering bleb"

Dr. Rick :

A filtering bleb is just that: A bubble that is made on purpose to give the fluid (aqueous) another way to filter outside of your eye and, thus, lower your pressure. In some cases the bleb is large enough to see on the side of the eyeball and, sometimes, even by the lower lid.

Customer:

all right-will it move where it's supposed to? It's very uncomfortable and distorting my vision. I got a second opinion on the bubble and the second doctor said that the surgery had a very good result but didn't offer an opinion on where the bubble would end up. It's driving me a little berserk.

Dr. Rick :

Over time it may shrink, but most likely, it will not. If it is too big, your pressures are too low (yours seem fine) or it is causing other problems then various treatments can be done to try to make it a bit smaller. This being said you don't want to close up the bleb all the way as the bleb is what the surgery was designed to make.

Customer:

Can I ask you directly if it will move? No one seems to want to answer that or may be unable to-I'm not sure. The position of it is very uncomfortable.

Dr. Rick :

No. It won't move. Like I said, give it "time" -- months perhaps -- so see where things settle out. If it is still a problem that it can be worked on. The only thing is that by trying to make it smaller the doctor could do "too good of a job" and the entire bleb could close up....causing the surgery to be a failure

Dr. Rick :

It will not move on its own. It might, maybe, shrink a little bit so it is not sticking out too much in the area it is bothering you....I had a patient once that the bleb was this huge thing on the entire nasel side of his eye. After about 7 months it stopped bothering him. I saw him about 12 years later and the bleb was still huge but his pressure was controlled without drops and he didn't seem to be bothered by the large bleb anymore. This is, of course, an extreme case......

Dr. Rick :

Do you know if your surgeon used mitomycin-C in during your trabeculectomy?

Customer:

I see-at least it's not dangerous and my pressures are good. Thank you for the direct answer. I'm a little worried that my vision will continue to be distorted by its position but will wait it out. Thanks for relating that experience. This bleb is pretty big but hopefully will settle out. I think that he did but don't know for sure-the anti-scarring stuff? I have to have a second surgery and am worried that I won't be able to see well enough to work.

Dr. Rick :

Yes, mitomycin c is the anti scarring stuff......Why a second surgery if I might ask? Cataract?

Customer:

In the other eye

Dr. Rick :

I was just about to say that :)

Dr. Rick :

Well, if you don't think that the surgeon who did the first eye is doing a good enough job of communicating with you I'd switch to another surgeon for the other eye. It is not enough to just be a good cutter if you can't help your patients to understand what is going on.....

Customer:

He's not a good communicator, I've come to realize but since the second surgeon said he did a really good job, i think I'll stick with him. Unless, of course, it's a matter of skill where the bleb ends up. It doesn't sound like it, though.

Dr. Rick :

not so much....those blebs seem to have a mind of their own even in the best of hands.

Dr. Rick :

Well, then, pin him to the wall when he comes in the eye lane and don't let him leave until he has answered your questions and calmed you fears :o)

Customer:

ok-I think I'll stick with the person who I know can do good surgery for the surgery and get my other information somewhere else. Maybe try to talk to him and draw all of this information out a little better. You just said that :) Thanks!

Dr. Rick :

My pleasure. Best of luck on your upcoming trabeculectomy and with this wayward bleb

Dr. Rick :

 


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Dr. Rick :

If you have questions after your next surgery or if I can be of any further service you can just ask for me on the main page. Take care.

Dr. Rick and other Eye Specialists are ready to help you
Let me know if there are there any other concerns or issues you would like to discuss on this topic.

If you have a chance drop me a note and let me know how things turn out. You can post to this thread or ask for me at the main screen at no additional charge.