Corneal Issues: Red Veins and Treatment Options

Corneal issues

Hello, I would like to ask you about the appearance of blood vessels on the cornea, which seems to cover almost one-third of the eyeball, making the eyes look red.
It doesn't seem to affect vision much, but it is not aesthetically pleasing.
My family members have had this condition as well, and after surgery, it grew back in a net-like pattern covering the eyeball.
I have heard that even after surgery, it can continue to grow back.
Is this true, or are there any methods for a permanent cure?

Linda, 30~39 year old female. Ask Date: 2002/09/20

Dr. Wang Yuwei reply Ophthalmology

It seems you are referring to "pterygium," which is typically an abnormal growth of tissue that extends from the inner corner of the eye towards the center of the cornea, often taking on a triangular or wedge shape.
The cause is excessive ultraviolet (UV) light exposure.
There is indeed a possibility of recurrence after surgery, so if it does not affect vision, it can be monitored.
However, it is best not to wait until it covers the pupil (the darker circle in the center of the eye) before considering surgery, to avoid leaving a scar in the central cornea.
Generally, ophthalmologists have some techniques to minimize the recurrence rate; additionally, whether or not surgery is performed, it is advisable to wear sunglasses or a hat to block UV rays to prevent the pterygium from growing faster.

Reply Date: 2002/09/20

More Info

Understanding corneal issues, particularly the appearance of red veins or blood vessels on the eye, can be quite concerning for many individuals. The condition you are describing, where blood vessels appear to cover a significant portion of the eye, is often referred to as "corneal neovascularization." This occurs when new blood vessels grow into the cornea, which is typically avascular (lacking blood vessels). While this condition can be aesthetically displeasing, it is essential to understand its implications and treatment options.

Causes of Corneal Neovascularization
Corneal neovascularization can result from several factors, including:
1. Hypoxia: One of the most common causes is a lack of oxygen to the cornea, often due to prolonged contact lens wear or poorly fitting lenses. The cornea relies on oxygen from the air, and when it is deprived, it may respond by growing new blood vessels.

2. Inflammation: Conditions such as chronic eye inflammation or infections can also lead to the development of new blood vessels as the body attempts to heal the affected area.

3. Trauma or Injury: Previous injuries to the cornea, such as scratches or chemical burns, can trigger a healing response that includes neovascularization.

4. Underlying Health Conditions: Certain systemic conditions, such as diabetes, can also contribute to changes in the eye, including the growth of blood vessels.

Treatment Options
The treatment for corneal neovascularization depends on the underlying cause and the severity of the condition. Here are some common approaches:
1. Addressing Underlying Causes: If the neovascularization is due to contact lens wear, the first step is often to discontinue the use of lenses and allow the cornea to heal. Switching to a different type of lens or using lenses that allow more oxygen to reach the cornea may also be recommended.

2. Medications: Anti-inflammatory medications, such as corticosteroids, may be prescribed to reduce inflammation and help control the growth of new blood vessels. In some cases, topical medications that inhibit blood vessel growth (anti-angiogenic agents) may be used.

3. Surgical Options: In more severe cases, surgical intervention may be necessary. Procedures such as corneal transplantation can be considered if the neovascularization significantly affects vision or if there are complications. However, as you mentioned, there is a possibility that blood vessels may recur even after surgical intervention.

4. Lifestyle Modifications: For individuals who wear contact lenses, ensuring proper hygiene and following recommended wearing schedules can help prevent hypoxia and subsequent neovascularization.

Prognosis and Recurrence
While corneal neovascularization can be treated, it is important to note that recurrence is possible, especially if the underlying causes are not addressed. Regular follow-ups with an eye care professional are crucial to monitor the condition and make necessary adjustments to the treatment plan.

Conclusion
In summary, while the appearance of red veins on the cornea can be concerning, understanding the underlying causes and treatment options can help manage the condition effectively. If you or a family member is experiencing this issue, it is advisable to consult with an ophthalmologist who can provide a comprehensive evaluation and tailor a treatment plan based on individual needs. Regular monitoring and addressing any underlying factors are key to preventing recurrence and maintaining eye health.

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