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PubMed This is a summary of 18 peer-reviewed journal articles Updated
Ophthalmology

Building Your Care Team: A Multi-Front Strategy

At a Glance

Managing neovascular glaucoma (NVG) requires a coordinated care team. You will need a retina specialist to treat underlying blood vessel issues, a glaucoma specialist to manage high eye pressure, and medical doctors like an endocrinologist to control systemic triggers like diabetes.

Because neovascular glaucoma (NVG) is a complex disease affecting both the front and back of the eye, you cannot be treated by a single doctor alone [1][2]. Successful management requires a “multi-disciplinary” team—a group of specialists with different expertise working together to save your vision and manage your health [3][4].

The “Eye Team”: Retina and Glaucoma

You will need two different types of eye surgeons who must stay in close contact regarding your treatment [2].

  • The Retina Specialist: This doctor focuses on the back of the eye. Their job is to treat the “root cause” of the problem: the oxygen shortage (ischemia) [5]. They will perform the anti-VEGF injections to shrink abnormal vessels and the PRP laser treatments to stabilize the retina [1][6].
  • The Glaucoma Specialist: This doctor focuses on the front of the eye. Their job is to manage the “result” of the problem: the high eye pressure [2]. They will prescribe pressure-lowering drops and perform surgeries like the Ahmed Valve or other drainage devices [7][8].

Why Communication Matters: Timing is everything. For example, a glaucoma surgeon may want the retina specialist to give you an injection a few days before surgery to reduce the risk of bleeding during the procedure [9][10].

The “Body Team”: PCP and Endocrinologist

Since NVG is often triggered by systemic conditions like diabetes or a vein occlusion, your eye doctors need your “body doctors” to help stabilize the environment inside your blood vessels [2][11].

  • Endocrinologist: If you have diabetes, this specialist is critical. High blood sugar (measured by your HbA1c) is directly linked to the progression of NVG [12][13]. Lowering your HbA1c can help make your eye treatments more effective [14].
  • Primary Care Physician (PCP): Your PCP helps manage hypertension (high blood pressure) [15]. Uncontrolled blood pressure can put further strain on the damaged vessels. Additionally, if your NVG was caused by a Central Retinal Vein Occlusion (CRVO), your PCP may need to conduct a thorough cardiovascular workup to check for underlying clotting disorders or severe cholesterol issues [16][17].

Preparing for Your First Visit

To help your specialists coordinate quickly, bring the following items to your first appointment:

  1. A Complete Medication List: Include dosages for eye drops, blood pressure meds, and diabetes medications.
  2. Recent Lab Results: Specifically your most recent HbA1c level and any recent blood pressure readings [12].
  3. Surgical History: Dates of any past eye surgeries, laser treatments (PRP), or injections [12][18].
  4. Specialist Contacts: The names and fax numbers of your other doctors so the specialists can send reports to each other immediately [3].

By building a team that communicates, you ensure that every aspect of this disease—both in your eye and in your body—is being addressed simultaneously [2][4].

Common questions in this guide

Why do I need both a retina and a glaucoma specialist for NVG?
Neovascular glaucoma affects both the front and back of your eye. A retina specialist treats the root cause by addressing oxygen shortages in the back of the eye, while a glaucoma specialist manages the resulting high eye pressure in the front.
How do my primary care doctor and endocrinologist help treat my eye condition?
Systemic conditions like diabetes and high blood pressure often drive the progression of neovascular glaucoma. Your endocrinologist and primary care doctor help stabilize your blood sugar and blood pressure, which makes your eye treatments more effective.
What should I bring to my first appointment with an NVG specialist?
You should bring a complete medication list, your past eye surgery history, the contact information for your other doctors, and recent lab results like your HbA1c and blood pressure readings.
Why is communication between my eye doctors so important?
Timing is critical in neovascular glaucoma treatment. For example, your glaucoma specialist may need your retina doctor to administer an injection a few days before eye surgery to reduce the risk of bleeding.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.How often do you and my retina specialist communicate about my case?
  2. 2.Which of you will be the 'lead' in coordinating the timing of my injections, laser treatments, and potential surgeries?
  3. 3.Do you have experience managing NVG cases that are similar in severity to mine?
  4. 4.What specific updates or data from my eye exams should I share with my endocrinologist or primary care doctor?
  5. 5.If I have a sudden spike in pain or vision loss after hours, which of your offices should I call first?

Questions For You

Tap a prompt to share your answer — we'll use it plus this page's context to start a tailored conversation.

References

References (18)
  1. 1

    Neovascular Glaucoma from Ocular Ischemic Syndrome Treated with Serial Monthly Intravitreal Bevacizumab and Panretinal Photocoagulation: A Case Report.

    Asif H, Si Z, Quan S, et al.

    Case reports in ophthalmological medicine 2022; (2022()):4959522 doi:10.1155/2022/4959522.

    PMID: 35935916
  2. 2

    [Current views on pathogenesis and treatment of neovascular glaucoma].

    Fedoruk NA

    Vestnik oftalmologii 2024; (140(3)):110-116 doi:10.17116/oftalma2024140031110.

    PMID: 38962986
  3. 3

    The role of Anti-VEGF agents in treatment of neovascular glaucoma.

    Palfi Salavat MC, Șeclăman EP, Barac R, et al.

    Romanian journal of ophthalmology 2022; (66(3)):209-213 doi:10.22336/rjo.2022.41.

    PMID: 36349171
  4. 4

    Anti-VEGF treatment is the key strategy for neovascular glaucoma management in the short term.

    Sun Y, Liang Y, Zhou P, et al.

    BMC ophthalmology 2016; (16(1)):150 doi:10.1186/s12886-016-0327-9.

    PMID: 27576739
  5. 5

    Risk Factors and Preventive Effects of Laser Panretinal Photocoagulation for Neovascular Glaucoma after Ophthalmic Stereotactic Radiotherapy.

    Ueda E, Yoshikawa H, Arakawa S, et al.

    Nippon Ganka Gakkai zasshi 2016; (120(10)):689-95.

    PMID: 30088402
  6. 6

    Neovascular glaucoma - A review.

    Senthil S, Dada T, Das T, et al.

    Indian journal of ophthalmology 2021; (69(3)):525-534 doi:10.4103/ijo.IJO_1591_20.

    PMID: 33595466
  7. 7

    Long-term outcome of surgical management in neovascular glaucoma: A retrospective, multicentric study.

    Pegu J, Garg P, Shakya R, et al.

    Indian journal of ophthalmology 2025; (73(Suppl 2)):S254-S259 doi:10.4103/IJO.IJO_3145_23.

    PMID: 39141503
  8. 8

    Baerveldt or Ahmed glaucoma valve implantation with pars plana tube insertion in Japanese eyes with neovascular glaucoma: 1-year outcomes.

    Suda M, Nakanishi H, Akagi T, et al.

    Clinical ophthalmology (Auckland, N.Z.) 2018; (12()):2439-2449 doi:10.2147/OPTH.S183689.

    PMID: 30568422
  9. 9

    Short-Term Outcomes of Trabeculectomy With or Without Anti-VEGF in Patients With Neovascular Glaucoma: A Systematic Review and Meta-Analysis.

    Zhou X, Chen J, Luo W, Du Y

    Translational vision science & technology 2023; (12(9)):12 doi:10.1167/tvst.12.9.12.

    PMID: 37728893
  10. 10

    The Optimization of an Anti-VEGF Therapeutic Regimen for Neovascular Glaucoma.

    Bai L, Wang Y, Liu X, et al.

    Frontiers in medicine 2021; (8()):766032 doi:10.3389/fmed.2021.766032.

    PMID: 35083234
  11. 11

    Acute angle closure glaucoma from spontaneous massive subretinal hemorrhage.

    Sosuan GMN, Domingo RED

    GMS ophthalmology cases 2019; (9()):Doc15 doi:10.3205/oc000104.

    PMID: 31157157
  12. 12

    Frequency and Risk Factors for Neovascular Glaucoma After Vitrectomy in Eyes with Diabetic Retinopathy: An Observational Study.

    Liang X, Zhang Y, Li YP, et al.

    Diabetes therapy : research, treatment and education of diabetes and related disorders 2019; (10(5)):1801-1809 doi:10.1007/s13300-019-0644-0.

    PMID: 31321746
  13. 13

    Risk factors for neovascular glaucoma after vitrectomy in eyes with proliferative diabetic retinopathy.

    Sakamoto M, Hashimoto R, Yoshida I, et al.

    Clinical ophthalmology (Auckland, N.Z.) 2018; (12()):2323-2329 doi:10.2147/OPTH.S184959.

    PMID: 30532517
  14. 14

    The effect of the intercellular adhesion molecule-1 and glycated haemoglobin on the management of diabetic neovascular glaucoma.

    Guzun OV, Zadorozhnyy OS, Velychko LM, et al.

    Romanian journal of ophthalmology 2024; (68(2)):135-142 doi:10.22336/rjo.2024.25.

    PMID: 39006326
  15. 15

    Types of Glaucoma and Associated Comorbidities Among Patients at King Abdulaziz Medical City, Jeddah.

    Talaat K, Fathi OT, Alamoudi SM, et al.

    Cureus 2021; (13(6)):e15574 doi:10.7759/cureus.15574.

    PMID: 34277196
  16. 16

    Predictors of Neovascular Glaucoma in Central Retinal Vein Occlusion.

    Rong AJ, Swaminathan SS, Vanner EA, Parrish RK

    American journal of ophthalmology 2019; (204()):62-69 doi:10.1016/j.ajo.2019.02.038.

    PMID: 30862502
  17. 17

    Predictors of Neovascular Glaucoma in Central Retinal Vein Occlusion.

    Rong AJ, Swaminathan SS, Vanner EA, Parrish RK

    American journal of ophthalmology 2019; (205()):201-202 doi:10.1016/j.ajo.2019.04.029.

    PMID: 31277883
  18. 18

    Early postoperative bevacizumab for preventing neovascular glaucoma in phacovitrectomy for proliferative diabetic retinopathy.

    Hwang S, Hong EH, Kang MH, Shin YU

    Scientific reports 2025; (15(1)):1231 doi:10.1038/s41598-025-85667-y.

    PMID: 39774391

This page provides educational information about building a care team for neovascular glaucoma. It is not medical advice, and you should consult your doctors to coordinate a personalized treatment plan.

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