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Medical Forum / General / Vision / August 2005

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Corneal Neovascularization

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Access - 20 Aug 2005 14:22 GMT
Hi,

I went to my contact lens specialist recently and in one eye I was told I
had the beginning symptoms of corneal neovascularization (new blood veins
growing into the cornea). I also see halos and "starbursts" around lights at
night. Should I stop wearing contact lenses ? And when I stop, will my old
eyesight return ? I'm 33 and highly myopic (8.50/9.00).

Thanks for all replies, i'm a bit worried about my eyesight.
LarryDoc - 20 Aug 2005 17:56 GMT
> Hi,
>
[quoted text clipped - 5 lines]
>
> Thanks for all replies, i'm a bit worried about my eyesight.

Neovascularization is sometimes a consequence of using soft contact
lenses with inadequate oxygen permeability and the body's response to
that. It does not happen to all contact lens wearers and when it is the
result of contact lens use, it must be addressed. Some people who use
low oxygen permeability lenses don't get it and rarely, some people who
don't wear lenses at all do!  In any event, the solution is to switch to
a lens with improved oxygen transmission (the silicone hydrogel group a
perfect example) or discontinue lens wear.

Neovasc is a condition at the extreme edge of the cornea (no competent
practitioner would allow conditions to persist that would let it advance
further) and halos and starbursts are not related symptoms. Those can be
the result of swelling of the cornea (also possibly as a result of
inadequate oxygen) or a lens optic zone smaller than your pupil.  

Your practitioner should be able to easily determine the cause(s) and
recommend appropriate remedies.  The neovasc if halted may go away and
not likely ever interfere with vision. The other symptoms also can be
resolved.

--LB, O.D.
Access - 20 Aug 2005 18:15 GMT
>> Hi,
>>
[quoted text clipped - 29 lines]
>
> --LB, O.D.

Well his answer was "let's follow this up within 6 months". So I don't have
the impression he's really concerned (although I am), maybe I should see an
eye doctor ? I'm not using soft contacts but wearing hard RPG's since 1991.
I quit wearing lenses for 2 days but my vision didn't return to what I would
refer to as the "normal" situation.
Mike Tyner - 20 Aug 2005 18:29 GMT
> Well his answer was "let's follow this up within 6 months". So I don't
> have the impression he's really concerned (although I am), maybe I should
> see an eye doctor ? I'm not using soft contacts but wearing hard RPG's
> since 1991.

Many doctors feel that minor neo deserves little concern. This comes from
the days of low-perm soft contacts, when many or most wearers exhibited
_some_ neo. There are two main varieties; short limbal vessels that don't
penetrate into the cornea more than a millimeter or so, and long, looping
vessels that threaten the central cornea. The second variety almost always
causes us to recommend discontinuation.

-MT
Dr. Leukoma - 20 Aug 2005 18:36 GMT
Speaking of long-looping vessels, I just saw such a case.  This 16 y/o
female wore methafilcon lenses.  She exhibited a "seafan" case of
bilateral neovascularization at 6:00, extending to within about a
millimeter or so of the pupil.  This sort of thing is so rare that I
long ago forgot that such things exist in a healthy subject.  I sent
her off to the local medical school for show and tell.

DrG
Access - 20 Aug 2005 22:08 GMT
> Speaking of long-looping vessels, I just saw such a case.  This 16 y/o
> female wore methafilcon lenses.  She exhibited a "seafan" case of
[quoted text clipped - 4 lines]
>
> DrG

And what was your advice ? No more contact lenses ? Did she have problems
with her eyesight ?
Dr. Leukoma - 21 Aug 2005 02:56 GMT
> And what was your advice ? No more contact lenses ? Did she have problems
> with her eyesight ?

I withdrew the contact lenses immediately.  And, to make sure that I
wasn't missing anything, I sent her to a corneal specialist at the
medical school.

She is now wearing Focus N&D lenses when she plays her varsity sport --
basketball -- and glasses the remainder.

The corneal specialist and I think that she sleeps with her eyes open
(based upon the appearance of the epithelium), and therefore has
chronic exposure keratitis.

Actually, she is probably going to do OK with the silicone-hydrogel
lenses.  But, this case requires close monitoring.

DrG
 
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