March 11, 2020
Intraocular injections are a common treatment for retinal diseases such as macular degeneration, retinal vein occlusion and diabetic retinopathy. Patients with these conditions risk permanent loss of central vision. Treatment as early and thoroughly as possible is important to save vision and prevent any further loss with these conditions. Intraocular injections maximize effectiveness with a highly targeted drug therapy that is accurately delivered.
An indispensable tool in retinal care
Intravitreal injections have become an indispensable tool for ophthalmologists to treat retinal conditions. Patients diagnosed with retinal diseases such as macular degeneration, retinal vein occlusion and diabetic retinopathy have an abnormal growth of blood vessels that leak blood or fluid blurring central vision due to the chemical vascular endothelial growth factor (VEGF). Anti-VEGF medicines stop the abnormal vessels leaking, growing and bleeding under the retina, stopping the theft of vision and impairment of a patient’s quality of life.
Injection medication management is diagnosed during clinical examinations and diagnostic testing such as with an optical coherence tomography (OCT). With many patients, Anti-VEGF medicines may need to be repeated and can be safely administered over several years.
What to expect
Performed in the office, intravitreal injections typically take about 10 to 15 minutes to complete with the actual injection taking less than 20 seconds.
Medications are injected directly into the space at the back of the eye called the vitreous cavity while patients sit inclined in the doctor’s office.
- Typically, the procedure begins by anesthetizing the eyelids with drops, a gel or small numbing injection to prevent any pain.
- A povidone-iodine solution is then used to clean the eye and eyelids, killing any bacteria that may reside there.
- A speculum, similar to a small clip, will keep the eye open.
- Looking in a particular direction, the eye is stabilized with a cotton tip or small forceps.
- The medication will then be inserted through the white of the eye with a very small needle. There may be some pressure, but minimal discomfort during the injection.
- The eye is cleaned once more to limit possible infection of the injection site.
- Antibiotic drops will be prescribed and recommended 4 times a day for about 5 days.
- Depending on the condition being treated, a follow up appointment will be scheduled about 4 to 6 weeks after the injection.
- There are very few restrictions advised after injections. Emphasis is on care to avoid contamination of the injection site.
The intraocular pressure (IOP) may be checked following the injection. Any rise in IOP usually returns to normal within a few minutes, but may take longer in patients with glaucoma and should be monitored more closely.
There may be some small bleed or subconjunctival hemorrhage on the surface of the eye at the injection site that will heal in about a week.
Small specks or floaters may be seen after the injection but should clear up within a few days and not worsen.
A reaction to the povidone-iodine used to clean the eye can create a gritty or sore feeling in the eye. Artificial tears can be used to ease the symptoms of this dryness and irritation.
Risks and complications:
With any medical procedure, there is always the chance of complications and risks. Anti-VEGF complications are rare and are most often the result of the injection itself, not the drug. Some side effects can include:
- Eye infection
- Retinal detachment
- Increased eye pressure
- Blood clots or bleeding from the eye
- Inflammation inside the eye
- Red eye
Anti-VEGF treatment risks are rare, however, a retina specialist should be contacted immediately should any of the following signs or complications occur:
- Significant vision loss
- Discomfort or pain in the eye
- Increased sensitivity to light
- Increased floaters after the first day of healing
Share your history with your doctor
Opthamologists, like any doctor, need to know your full medical history. Before treatment can occur, your doctor needs to be aware of any possible issues that may complicate the procedure or the effects of treatment. Some medications may interfere with the effectiveness of the medication as well as some personal medical conditions.
Anti-VEGF should not be administered with the following conditions:
- Allergy to anti-VEGF or any of its ingredients
- An infection in or around either eye
- An infection in the body
- Pregnancy, breastfeeding or if trying to become pregnant
Caution should be considered in patients:
- Having had a heart attack or stroke in the past 6 months
- Uncontrolled angina
- Uncontrolled high blood pressure.
Are intraocular injections right for you?
The right treatment will depend on the diagnosis of your specific condition. Dr. Weber and the professionals at Island Retina provide the most state-of-the-art retinal diagnosis and treatment in a private and comfortable setting.
Specializing in the intraocular injections of FDA-approved medications such as Eylea, Lucentis, Avastin or Macugen, Island Retina is the right choice in determining the vision care path appropriate for your needs. Contact Island Retina if you or a loved one struggle with retinal conditions.