Cornea and External Diseases

Corneal Neovascularization

Superficial corneal neovascularization commonly associated with extended-wear contact lens. Note the branching pattern of the newly formed vessels.
  • Pathologic ingrowth of vessels from the limbal vascular plexus into the cornea.

Clinical Features

  • Symptoms: may be asymptomatic or mild to severe decrease of vision.
  • Signs:
    • Fine, superficial neovascularization is most commonly seen in contact lens wearers, and also can be associated with blepharitis, superior limbic keratoconjunctivitis, vernal conjunctivitis and many others
    • Pannus or deep stromal neovascularization can be seen in eyes with extended use of contact lens, chronic blepharoconjunctivitis, keratitis, trachoma, toxic chemical injuries, graft rejection and phlyctenulosis.

Management

  • Causes: infection, contact lens wear, trauma, chemical burn, immunologic diseases, degeneration or intraocular events such as uveitis, glaucoma and pthisis bulbi.
    • Supportive, which directed at eliminating the underlying condition.
    • Topical corticosteroid may be applied for gross and active vascularization.
    • Diathermy of large feeding vessels and corneal laser photocoagulation has been among the surgical modalities to treat pannus.
    • Limbal grafting may be required in eyes with severe chemical injuries and limbal epithelium loss