What Is Corneal Neovascularisation?
Corneal neovascularisation is a condition where abnormal blood vessels grow into the cornea—a part of the eye that is normally transparent and free of blood vessels. This invasion of vessels can impair vision and may lead to complications if left untreated.
The primary cause of this condition is oxygen deprivation (ocular hypoxia), often linked to extended or improper contact lens wear. The condition can also result from ocular trauma, infections, or underlying health conditions such as Sjögren’s syndrome or rosacea.
Why It Happens
The cornea depends on oxygen and nutrients from tears and the surrounding atmosphere. When it becomes deprived—most commonly due to tight or oxygen-blocking contact lenses—the body responds by growing blood vessels into the cornea, which disrupts its transparency and function.
Common causes include:
- Long-term or improper contact lens wear
- Viral infections (e.g., herpes simplex)
- Corneal ulcers or trauma
- Autoimmune diseases (like acne rosacea or Sjögren’s syndrome)
- Poor hygiene and follow-up care in contact lens wearers
Signs and Symptoms to Watch For
In many cases, early signs may only be visible during an eye examination. As the condition progresses, symptoms may include:
- Redness around the cornea (limbal hyperemia)
- Blurring of vision, especially when wearing contact lenses
- Eye sensitivity to light
- Yellow-white lipid deposits in the cornea
- Decreased tolerance for contact lenses
- Engorged or branching vessels in the cornea
- Dryness, discomfort, or inflammation
- Corneal scarring or haemorrhage in severe cases
Risk Factors to Note
You may be at greater risk for corneal neovascularisation if you:
- Wear hydrogel contact lenses
- Wear lenses for extended periods without breaks
- Use poor lens hygiene or infrequent replacements
- Have dry eye syndrome, high myopia, or chronic inflammation
Early detection through regular eye exams is crucial—especially for long-term contact lens users.
Potential Complications
If left untreated, corneal neovascularisation can lead to:
- Permanent vision impairment
- Corneal scarring or ulceration
- Severe inflammation and lipid accumulation
- In extreme cases, corneal transplant may become necessary
How Neovascularisation Is Treated
Treatment focuses on halting vessel progression and preserving vision. Management depends on the severity and underlying cause:
Non-Surgical Treatment
- Stop or limit contact lens use immediately
- Switch to high oxygen-permeability lenses (e.g. silicone hydrogel or rigid gas permeable lenses)
- Topical corticosteroids for active inflammation
- Artificial tears for dry eye management
- Anti-VEGF treatments like bevacizumab to reduce blood vessel growth
- Treat underlying causes such as blepharitis, rosacea, or infection
Advanced & Surgical Options
- Refitting of lenses or discontinuation altogether in advanced cases
- Superficial keratectomy to remove surface vessels
- Photodynamic therapy or argon laser obliteration of vessel lumens
- Amniotic membrane transplantation for corneal healing
- Corneal transplant surgery in cases of central scarring, though risk of rejection is high
Wearing contact lenses and noticing redness or discomfort in your eyes?
Book a detailed eye health evaluation with Davida van der Merwe Optometrist to detect early signs of corneal neovascularisation and protect your vision.
