Any treatment options for Corneal neovascularization?

Question

I am 25 years old and was diagnosed with Corneal neovascularization. I know the basics of this disease and I am spreading the seriousness of this of this disease to everyone I know so they can prevent this. I’ve been wearing contact since I was 14 years old. I’ve had keratitis and countless vision problems. My prescription is -10.00/-10.50. My ophthalmologist told me I have a bad case and basically told me I can never wear contacts again. How true is that? Can I wear hard contacts? Is there any treatment options or therapies? Eye drops, Ointments, Surgeries? Should I get a second opinion? I don’t mind wearing glasses but my prescription is very high… I just feel I was given a one-sided answer. So many advances in technology today and I wasn’t given any options…

Answer 1

Thanks for spreading the seriousness of this, we do what we can, but everyone thinks it can't happen to them.

There is no treatment, you have to let your eyes heal and NO contacts. I talked to my doctor (my boss) and he said it really depends on how severe it is on if you can ever wear contacts again. You may be able to wear a lens with a very high oxygen transmission, like the Ciba Focus Night and Day, but you'll never be able to sleep in them or wear them for extended hours. You know that you have blood vessels growing into your cornea, those vessels will not go away although once you stop wearing the contacts, the blood IN the vessels will go away and you will be left with what we call "ghost vessels". Because of the ghost vessels, it will be easier for the blood to come back into them if you over wear or abuse your contacts again. You may be able to wear contacts again, but you have to let your eyes heal and the blood to get out of the vessels before you can even think about contacts again. Wait 6 months and have your eyes checked again, if you still can't wear contacts, wait another 6 months and get them checked again.

I know you know this, this is for everyone else who may read this. Your eyes need to breathe just like your mouth, wearing a contact on your eye is basically doing the same thing with your hand over your mouth. You can still breathe, but it is harder. If you over wear, sleep in, abuse, or not properly clean your contacts, your eye will not get enough oxygen and start to grow blood vessels into your cornea. This is very, very bad, if you can't tell by the desperate plea for contacts...

I'm sorry I don't have the answer you want, it's one of those things that depend on your eyes and your doctor. No doctor wants to tell you it's okay to wear contacts and have the neo advance and get sued.

Answer 2

Corneal neovascularization is a very serious problem in long term contact lens wearers. It results from over use of CLs. It causes lack of oxygen to the cornea and therefore the vessels in the eye will form new vessels looking for more ways to collect oxygen. The best treatment is to reduce CL lens wearing to a minimum or not at all. I know this is tough to come by when you're so used to it but it's the best option.

The following picture is the basic formation of how it begins. We do not want for it to get to his point because it'll only get worse.

http://www.eyetec.net/group7/images/m36_...

Over time if you're still wearing contacts and not listening to your eye doctors, you can slowly lose your vision permanently. Using artificial drops for the eyes will be good for long term relief. Not vasoconstrictors like visine and eye drops of that nature. Those are just cosmetic relief which makes it looks like your eyes are better but in reality it'll get worse over time.

My suggestion for treatments would be the following.

1. decrease wearing time to minimal to nothing at all.

2.  Refit into high oxygen transmissibility lens material (high DK material).  New silicon hydrogel material is 5-7X more oxygen permeable compared to the traditional soft plastics (eg Acuvue2).  It will stop the progression of neovascularization and maybe worn for up to 24hrs a day without complications.

3. FREQUENT Follow-up visits for progress check. This is important if you're concerned about the long term health of your eyes.

Surgery may be possible but it depends on the severity of your condition. Talk to your ophthalmologist in your area and see what you can do.

Answer 3

The cornea is an avascular structure. It has no blood vessels in it, normally. But some people decide that they have to use contacts because the glasses they have to wear otherwise are too thick or unsightly or ?.

In the range of -10, you are +10.00 too powerful. The contacts to correct this are a bit 'thicker' than usual. Since the lens you use doesn't allow enough oxygen to enter the cornea through the lens itself, and the amount of oxygen that your tear film provides and the vessels from the sides of the cornea as well, the cells in the cornea send a message that there's not enough oxygen.

So your body grows new blood vessels towards that cells that are sending that message.

As the photo shows, these are not 'nice' blood vessels. And if you grow those over the center of the cornea, your vision will drop as your cornea won't be clear anymore. Is it surgically repairable? Sure.

Maybe it might be a better idea to have a refractive lens exchange or a piggyback lens placed in front of your normal lens inside your eye. That way your Rx is taken care of and you won't need the contacts, which you shouldn't wear anyway.

Your best bet is to think clearly on this. NO ONE cares whether or not you wear contacts or glasses, but YOU. I'm pretty sure you don't care whether I wear them, do you? Talk to you ophthalmologist about surgical correction of your myopia by the two methods mentioned above. DO NOT CONSIDER REFRACTIVE LASER SURGERY FOR THIS.

better said, you might think of it this way:

DO NOT CONSIDER REFRACTIVE LASER SURGERY TO CORRECT THIS!

And that doesn't consider how many thousands of surgeries this person has done, nor that he's the best in the world, nor that he's a professor at the university of batville, just DON'T.

It's not that the surgery to correct this is all that hard. But you've already demonstrated that you are going to have a fairly rough post op. DO you like putting drops in your eyes hourly? me nether.

There are some who would consider PDT like surgery where you are given a dye in your vein and after 15 minutes a red laser is shinned onto your cornea for 83 seconds or ? time, and the abnormal vessels which have taken up that dye will clot and atrophy. The 'normal' vessels don't take up the dye. This is used in retina surgery fairly often, but am not sure whether cornea surgeons use this technique.

And, I'd have a cornea specialist look at you BEFORE you make ANY therapeutic decision. I'm not talking about a general ophthalmologist. See one or more cornea specialists.

If you've more questions, after you talked with your own ophthalmologist about this, let me know. I'm not sure I can help, but should be able to give you ideas of how to proceed or how NOT to proceed.