Neovascular Glaucoma

Question 1

What is the aetiology of neovascular glaucoma?

Answer 1

• Secondary to proliferative Diabetic retinopathy and ischaemic CRVO

Question 2

What is the pathogenesis for secondary open angle neovascular glaucoma?

Answer 2

• Due to ischamic environment new vessels grow causing a fibrovascular membrane than block the trabecular meshwork.
• This prevents aqueous outflow and IOP rises.

Question 3

What is the pathogenesis of closed angle neovascular glaucoma?

Answer 3

• The new vessel’s fibrovascular membrane contracts pulling the peripheral iris over the trabeculum, closing the angle.

This makes the IOP greater than the open angle one.

Question 4

What are the signs of neovascular glaucoma?

Answer 4

• Red spots/tufts at the pupillary margin growing radially across the iris.
• Raised IOP
• Red Eye

Question 5

What are the symptoms of neovascular glaucoma?

Answer 5

• Painful
• Red eye
• Halo’s around light
• Blurred vision

Question 6

What is the management of neovascular glaucoma?

Answer 6

• Emergency (same day) referral

Question 7

What is the treatment for neovascular glaucoma?

Answer 7

• Pan retinal photocoagulation and anti-VEGF injections

- Medical treatment for the IOP (prostaglandins)