What is Neovascular Glaucoma?

Individuals with diabetes are aware of the need to closely monitor a variety of health factors including blood sugar, blood pressure, diet, and exercise habits. Diabetes is not a disease that affects only one aspect of health—it can affect mobility, vision, and overall quality of life. 

Diabetic retinopathy is the leading cause of blindness in working-aged adults, and it can introduce a host of secondary eye complications. Neovascular glaucoma is one vision-threatening eye condition that is secondary to the development of diabetic retinopathy.

What are the Causes of Neovascular Glaucoma?

Individuals with diabetes can develop diabetic retinopathy, which affects the blood vessels of the eye. If inadequately treated, there is inadequate circulation to the retina with ischemia. The retina then forms new blood vessels. Unfortunately, these are abnormal and are more prone to leakage and scarring. These new vessels can be present elsewhere in the eye as well. When they are on the iris, they can cover the trabecular meshwork, that is the drain of the eye, resulting in elevated intraocular pressure and glaucoma damage. Neovascularization and glaucoma can also result from any disease process that results in retinal ischemia, such as retinal vascular occlusions and carotid insufficiency.

Neovascular Glaucoma Symptoms

Symptoms of neovascular glaucoma include headaches, nausea, light sensitivity, severe eye pain, eye redness, and overall vision loss. 

Much like diabetic retinopathy, neovascular glaucoma symptoms are not severe when the disease first develops. One of the best ways for patients to stay on guard against neovascular glaucoma is to receive regular eye exams from a specialist. In most cases, there is a progression of the stage of diabetic retinopathy from mild to moderate to severe to proliferative. Neovascular glaucoma occurs during the proliferative stage. In general, patients should be watched more frequently the more advanced the stage of their retinopathy. Regular exams can ensure early detection prior to the development of severe symptoms for the greatest chance of vision-saving intervention.

Treatment of Neovascular Glaucoma

If neovascular glaucoma is detected, treatment options include: 

• Anti-VEGF injections prevent the further growth of abnormal blood vessels in the eye and cause regression of new vessels. These must be performed repeatedly. Laser photocoagulation is performed to provide long-term reduction of the new vessel formation.  

Lowering pressure in the eye will reduce the risk of vision loss from neovascular glaucoma. Treatments for lowering eye pressure vary in intensity, from glaucoma drops to incisional glaucoma surgery options like a trabeculectomy or a tube shunt.

Improving Neovascular Glaucoma Patient Outcomes

Neovascular glaucoma is a condition that is challenging to diagnose and treat due to its asymptomatic nature in its early stages and the need to effectively address the underlying cause. 

Prevention of proliferative retinopathy is the best way to decrease the development of neovascular glaucoma. This can be optimized by having all patients with diabetes evaluated for the severity of retinopathy if present and implementing effective intervention prior to reaching the proliferative stage. Prevention and early detection due to a high level of suspicion are key to improving patient outcomes for neovascular glaucoma. Because this eye condition is a secondary condition to other eye diseases, the progression of this disease occurs in a true domino effect, from diabetes to diabetic retinopathy to neovascular glaucoma. Therefore, it is the responsibility of health providers to effectively prevent the development of neovascular glaucoma by connecting patients to proper resources at the beginning of their diabetes or diabetic retinopathy diagnosis. 

A key element of these prevention efforts for all diabetes-related eye conditions is access to specialists and screenings for diabetic retinopathy through teleretinal imaging.

While the responsibility of screenings for diabetic retinopathy used to fall solely on the shoulders of ophthalmologists and other specialist eye care providers, IRIS Now is a screening solution that opens the opportunity for primary care and in-home health providers to conduct comprehensive and accurate teleretinal imaging for diabetic retinopathy detection. 

These advancements in teleretinal imaging are instrumental in closing patient care gaps and increasing the ability of local providers to conduct screenings, which can be the first step in maintaining quality eyesight for patients.

Reach out to IRIS today to find out more about how your organization can fight against neovascular glaucoma, diabetic retinopathy, and other diabetes-related eye diseases with IRIS.

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FAQs

What is neovascular glaucoma?

Neovascular glaucoma is a secondary eye condition that develops as a result of eye diseases such as diabetic retinopathy, ischemic central retinal vein occlusion, and ocular ischemic syndrome. If neovascular glaucoma is not diagnosed and effectively treated, total vision loss usually occurs.

Can neovascular glaucoma be cured?

No, but preventative treatment can reduce the risk of it occurring, and if present, effective treatment options are available to minimize vision loss.

What causes neovascular glaucoma?

Neovascular glaucoma is caused by ocular ischemia that results in the formation of abnormal blood vessels that block eye fluid from draining properly. The buildup of this fluid leads to damage to the optic nerve, which results in eventual vision loss.