Eye Surgery FAQ

I underwent a type of eye surgery called a trabeculectomy last year, and I wonder whether this has any implications for scuba diving.
Trabeculectomy, a surgical procedure commonly used to treat glaucoma, involves the removal of part of the eye's trabecular meshwork and the establishment of a mechanism for draining fluid from the eye to reduce intraocular pressure. 

The aquatic environment is home to pathogens that may infect incompletely healed surfaces of the cornea, sclera, conjunctiva or eyelid or may enter the eye through unhealed corneal or scleral wounds, which could result in vision-threatening endophthalmitis (an infection inside the eye). The risk of infection from exposure to water is greater when diving in potentially contaminated ocean, river or lake water than when showering or bathing in treated municipal water. Thus, experts recommend waiting at least two months before returning to diving.

Even after this postoperative recovery period, there is a theoretical risk of pathogens gaining access to the anterior chamber of the eye through the conjunctiva. But this has not been reported as a complication of diving. The risk to divers of this complication would be expected to be smaller than that to swimmers because of the barrier function of the face mask, and it is not common practice to recommend that people who undergo this procedure avoid swimming (beyond the immediate postoperative period).

A mask squeeze could result in subconjunctival bleeding and/or swelling that could compromise the function of an implanted filter. The risk of this is small, however, because of the low incidence of significant mask squeeze. We are unaware of any reports of the loss of a functioning filter as a result of this complication.

Both the risk of filter compromise following mask squeeze and the risk of infection are small (we are unaware of any reported cases of either), but they should still be considered when making a decision about returning to diving. If you choose to continue diving after a trabeculectomy, take special care to avoid face-mask barotrauma.
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