Neovascular Glaucoma

Neovascular glaucoma is an extremely serious end-stage blinding disease that is less common than "primary open angle glaucoma" or "primary angle closure glaucoma", and as a result it is often discussed as an afterthought rather than the focal subject in reference books dedicated to this subject. Neovascular glaucoma is an extraordinarily aggressive type of secondary glaucoma that is considered an end stage complication in patients who have specific types of underlying retinal diseases, most commonly diabetic retinopathy and retinal vein occlusions. In neovascular glaucoma, the blood flow to the eye is insufficient, abnormal blood vessels grow into the eye to bring more oxygen, but these abnormal vessels can grow into the eye's natural aqueous outflow drainage system and block aqueous fluid from draining out of the eye. This causes pressure to build up in the eye, which, if left untreated, will cause permanent damage to the optic nerve and permanent vision loss - this is called neovascular glaucoma. Historically, NVG has been one of the most difficult types of glaucoma to treat, with a high failure rate for traditional glaucoma surgery, and often progression of the underlying retinal disease despite "standard of care" treatment, but in recent years there have been many advances in the treatment of neovascular glaucoma, especially with the advent of anti-vascular endothelial growth factor (anti-VEGF). Additionally, glaucoma surgeries have also become more advanced and less invasive in recent years, with the advent of a new category of glaucoma surgery called microinvasive glaucoma surgery (MIGS). The ophthalmology community deserves an up-to-date reference book regarding current concepts in the diagnosis, medical, laser, and surgical treatment of neovascular glaucoma in the anti-VEGF era, with attention to the close collaboration between glaucoma specialists and retina specialists. This is that reference. Written within the Essentials in Ophthalmology series, this novel update has the opportunity to change the way ophthalmologists treat NVG, ensuring patients better outcomes.