Filtering dysesthetic bleb with circumferential intrapalpebral extension

Bleb dysesthesia, a rare condition encountered post-trabeculectomy, can be a severe issue interfering with the patient's quality of life. Preserving bleb function while alleviating the subjective symptoms remains a challenge in managing such patients. Intensive lubrication is generally accepted as the best initial management, whereas surgical options are reserved for non-responding cases as they carry an inherent risk of bleb failure. Here, we report a case of bleb dysesthesia within 2 months of trabeculectomy. The bleb was extensive and did not respond to conservative management. It was managed successfully by combined surgical approaches, temporal compression sutures and nasal bleb-limiting conjunctivoplasty.