Policyholder Services

Is bleb needling permitted under Surgery Class 2 coverage?

A bleb is a bubble-like blister of the conjunctiva that may be caused by a pathologic condition or as a surgical result. When trabeculectomy is performed for the treatment of some forms of glaucoma, a new drainage channel is created to enhance the drainage of fluid from the eye and reduce intraocular pressure. The resulting flap of tissue that forms over the drainage channel and serves as a fluid reservoir is a bleb. During the postoperative period, scar tissue or cysts may form, reducing the flow of fluid from the eye.  Bleb needling may be needed to reopen the drainage channel.

Although bleb needling may be performed as an in-office procedure, significant complications such as infection, bleeding, choroidal effusion, and even loss of sight from supra-choroidal hemorrhage can occur. Because of these potential complications, Surgery Class 3 rating is required for coverage of this procedure.