What medications can be injected into the eye?
The common medications which require to be injected are anti-VEGF agents, designed to reduce abnormal blood vessel formation and leakage of fluid from blood vessels. These are used in wet macular degeneration treatment and in the treatment of diabetic maculopathy, as well as occasionally in some rarer conditions. Commonly used agents include ranibizumab (Lucentis®) and aflibercept (Eylea®).
We also sometimes need to inject steroids, such as the small Ozurdex® implant, other medications such as “clot busting” drugs like Tissue plasminogen activator (tPA) and occasionally bubbles of air or gas. These are all used for different conditions and the treatment will be discussed with you by your surgeon if you require it. The approach for the injection remains the same in all cases.
What happens during an intravitreal injection?
The procedure takes only a few minutes and is usually done in a clean room in clinic. We ask you to lie down on a bed and ensure that you are comfortable for the procedure. Anaesthetic eye drops will be administered and the area around the eye will be cleaned with an antiseptic solution. A cover will be placed over half of the face to ensure cleanliness and comfort. The injection is given via a tiny needle through the white of the eye. When the medicine is injected into the eye, you will feel some pressure for a second or two, but not any pain. We may sometimes give you drops to take away to use after the procedure.
What can I expect afterwards?
You should not have any pain or change in vision after the procedure. Sometimes the eye can feel a little gritty and you may use lubricating drops to ease this feeling. There may be a few floaters in your vision, which should settle. Occasionally there is a little red mark or bruising at the injection site, however usually there are no outward signs that an injection has taken place.
If there is any increasing pain or visual reduction in the days after the procedure, it is important to contact your ophthalmologist promptly to discuss this.
How frequently will I need to have injections?
Your individualised treatment plan will be discussed with you by your ophthalmologist. In the case of anti-VEGF medications, it is common to need three injections, one month apart, followed by an assessment. Further injection frequency is guided by the eye’s response to the treatment. Some patients require many injections in order to stabilise and control their condition, others will only need a few. We can usually increase the time period between injections as treatment progresses.