Slitlamp anterior segment optical coherence tomography (SL-OCT) (Heidelberg Engineering, Heidelberg, Germany) allows for direct imaging of filtering blebs after trabeculectomy and can be used to assess the internal anatomy and function of these blebs. Needling with subconjunctival injection of antifibrotic agents has been reported for failing blebs with encouraging results.1-4 We describe a new use of SL-OCT by performing SL-OCT–guided needling for restoration of bleb function.