Resolution of a late-onset conjunctival bleb following blunt ocular trauma in a pediatric patient: A possible role for topical gentamicin

Abstract:

Spontaneous conjunctival blebs are rare in children, with no clear treatment guidelines. We describe a 16-year-old boy with a gradually enlarging conjunctival bleb in the left eye, extending onto the cornea, years after blunt ocular trauma. In the absence of standard therapy, topical gentamicin was used empirically to induce localized fibrosis, capitalizing on its known adverse effect of conjunctival scarring. The bleb gradually regressed and completely resolved over 9 months, leaving subconjunctival fibrosis with no recurrence. This outcome suggests a potential therapeutic role for intentionally using drug-induced fibrosis in select cases. To the best of our knowledge, we found no previously published pediatric reports describing the deliberate use of topical gentamicin to induce conjunctival fibrosis for the treatment of a spontaneous conjunctival bleb. This report demonstrates a novel, nonsurgical management strategy and raises the possibility of repurposing ocular drug toxicities for therapeutic benefit in ophthalmology.