Complications: Blebitis

Abstract

If the patient seems (1) capable of adhering to an aggressive topical regimen, (2) to be expected to follow-up for continued clinical monitoring, and (3) if the case is not severe (e.g., less than 3+ cells), then the patient can be treated in an out-patient setting. It is generally acceptable to use topical fourth generation fluoroquinolones, such as gatifloxacin 0.3% and mox-ifloxacin 0.5% [1]. On initial presentation, the antibiotics should be dosed every hour (around the clock). Oral third and fourth generation fluoroquinolones can be added in conjunction with topical medications, as they do have some intraocular/vitreal penetration [2, 3]; fourth generation oral fluoroquinolones have better intraocular penetration compared with oral third generation fluoroquinolones [4-6]. Alternatively, fortified topical drops of cefazolin 5% (or vancomycin 2.5%) and tobramycin 1.5% can be considered and dosed every hour, each separated by 30 min that is, the patient receives a dose of the first or second medication every 30 min [1]. © 2010 Springer-Verlag Berlin Heidelberg.