The word of the intravitreal injection could raise a number of concerns. These may be related to pain, duration of treatment and post-treatment activities. Below are some of the questions that people usually have, especially when this is their first time getting an eye injection. When you know what to expect, you will be better prepared for your appointment.
Intravitreal injections are among the methods of treatment whereby drugs are injected into the vitreous, which is the gel in the eye. With this technique, drugs can be injected into the retina, the back part of the eye where most eye diseases occur. With this procedure, it may help to reduce swelling, prevent growth of abnormal blood vessels, as well as maintain your vision.
At Retina and Vitreous Surgeons of Utah, we provide treatment of problems in retina, macula and vitreous. Knowing what to expect from before, during and after the eye injection will make you better understand the treatment process.
What Is an Intravitreal Injection?
An intravitreal injection consists of injecting medicine into the interior part of the eye between the retina and the lens. Retina is the posterior light sensitive tissue in the eye that helps one see. The center portion of the retina is referred to as the macula, and it is responsible for vision in the central part.
The other causes of diseases of the eyes include build-up of fluid in the retina or leaking/bleeding from abnormal blood vessels. Some drugs need to be used in the eye. This drug is therefore injected into the eye to give it the best chance of getting to the affected site unlike when just eye drops or tablets would be used.
The drug used will be chosen by your retinal specialist based on your disease, eye exam, prior treatments, and response to previous treatments. Other medicines are injected into the body to interfere with a protein known as vascular endothelial growth factor (VEGF). There are some medications that can be prescribed to help reduce the inflammation or cure the infection.
This procedure looks very scary, but it is a common procedure performed on the retina. Your doctor will explain to you why he/she thinks this treatment will be beneficial to you.
Why Might You Need an Eye Injection?
Injections into the eye are required when a retinal disease might influence one’s central vision or produce any inflammation in the eye. This depends on one’s diagnosis and the outcomes of the eye examination.
1. Age-related Macular Degeneration
Age-related macular degeneration (AMD) is an eye condition where there is damage done to the macula, which makes one unable to read, recognize people, and see details. Wet AMD is a condition when new, abnormal blood vessels grow under and around the retina, and they are leaking the fluid or the blood.
Injections with medication that inhibits VEGF prevent formation of new blood vessels and stops them from leaking. Injections may not only help preserve one’s eyesight but also improve it. The amount of injections varies individually.
2. Diabetic Retinopathy
Diabetic retinopathy is an eye disease that develops because of high blood sugar, damaging small blood vessels in the retina. Those vessels either start to leak, close off, or cause formation of abnormal blood vessels.
Depending on the state of one’s illness, the physician chooses the type of treatment.
3. Diabetic Macular Edema
Diabetic macular edema is a case where fluid accumulates in the macula due to damage to the blood vessels within the retina. This may result in blurred or distorted vision.
By means of intravitreal injection, the swelling may be reduced or stabilized, thereby improving your vision. The eye doctor will monitor your macula and adjust your therapy depending on the reaction.
4. Occlusion of Retinal Veins
Occlusion of the retinal vein takes place when the retinal vein that is meant for carrying blood from the retina gets blocked. This will cause leaking of fluid, swelling of the retina, and changes in vision.
Based on the severity and location of the blockage, an injection in the eye may reduce macular edema and save vision.
5. Other Retinal Diseases
Apart from the above diseases, there are other circumstances where your eye doctor may choose to inject you with some medication in order to treat macular edema, intraocular inflammation, or eye infection.
| Condition | What Happens in the Eye | How the Injection Helps |
|---|---|---|
| Age-related Macular Degeneration (AMD) | The macula is damaged. In wet AMD, abnormal blood vessels grow under and around the retina and leak fluid or blood. | Anti-VEGF medication stops new vessels from forming and leaking, which can preserve or improve eyesight. |
| Diabetic Retinopathy | High blood sugar damages small retinal vessels, which leak, close off, or form abnormal vessels. | Treatment type is chosen based on the stage of the disease. |
| Diabetic Macular Edema | Fluid builds up in the macula, causing blurred or distorted vision. | Swelling is reduced or stabilized, which can improve vision. |
| Retinal Vein Occlusion | A retinal vein is blocked, causing fluid leakage, retinal swelling, and vision changes. | May reduce macular edema and save vision, depending on severity and location of the blockage. |
| Other Retinal Diseases | Macular edema, intraocular inflammation, or eye infection. | Medication is chosen to treat the specific problem. |
What to Anticipate Before the Intravitreal Injection?
Preparing for intravitreal injections is fairly easy and depends mainly on one’s condition and on the medicine used for the therapy.
1. Examination of Your Eye Condition and Evaluation of Your Medical History
Before the injections are administered, your retinologist can ask you about your symptoms, background, the medicines you are taking, your allergies, and the previous treatments you received for your eyes. You should talk about your previous symptoms of eye infections, irritations, pains, or other ailments.
Do not forget to tell your doctor about the medications you take – both prescribed and over-the-counter as well as vitamins. This information is crucial and can help a doctor make a proper decision regarding whether you need to have an injection.
2. Get Familiar with Info About Injection Procedure
It is imperative that the doctor explains the rationale of the injection, the nature of the injection, and the expected outcomes of the injection. It is extremely important to inquire on how often you need to visit for the injection and how your progress will be evaluated.
3. Follow the Advice of Your Clinic
Your clinic may give you some advice on eye drops, cleanliness, and medications before the injection. You have to follow the advice of your clinic. Do not take any antibiotics, eye drops, or other medicines without the advice of your physician.
4. Plan for Transportation if Required
Since the vision may become blurred and sensitive to light due to the dilation of pupils before the test, you should make arrangements for transportation since it is your first injection and you do not know what your vision will be after the test.
It is recommended to wear sunglasses due to bright surroundings.
What Happens During an Intravitreal Injection?
The actual injection process does not last long, though preparation and waiting could extend the duration of the entire appointment. The process may differ depending on your personal condition and the preferences of the clinic where the injection is performed.
Step 1: Examination and Eye Preparation
Prior to the treatment, your medical care provider might conduct vision and retina examination, as well as take images of the latter using optical coherence tomography (OCT) in order to evaluate the degree of any swelling or other changes.
Then, your treatment area is prepared. The eye and its surrounding skin are thoroughly washed with antiseptic liquid in order to avoid infections. Your doctor follows all the necessary sterile practices during the treatment.
Step 2: Numbing the Eye
For your comfort, eye drops or other numbing technique is applied prior to the treatment process. Though you may feel some pressure and discomfort, let your medical care team know in case of severe pain.
A numb eye is not supposed to feel anything. Your doctor explains all the steps to you.
Step 3: Holding Your Eyelids Open
A small instrument known as an eyelid speculum may be used to keep your eyelids open throughout the process to ensure that blinking doesn’t occur during the injection process.
Although this might feel odd, this equipment is used to make sure that your doctor performs the procedure effectively and efficiently. You will be instructed on what you need to focus on during the injection process.
Step 4: Injecting the Medicine
Your retinal specialist will instruct you to focus at a specific point while the injection is being made into your eye. The injection itself will take just a few seconds.
You may experience pressure in your eye, some pain, or even a stinging feeling during the procedure. It is also possible to experience a bubble after the procedure. Different people experience different feelings depending on the medicine and person.
After administering the medicine, the doctor will complete the process and ensure that you are fit to leave.
Step 5: Receiving Aftercare Instructions
Prior to your departure, you will be given advice on what to expect and how to handle any pain or symptoms that require immediate treatment. Be sure to ask your doctor who to contact if something should arise following your departure.
Does an Intravitreal Injection Hurt?
Painful injections in the eyes are some of the commonest fears concerning eye injections. While the mere thought of a needle next to your eyes sounds very scary, the eyes are always numb by the time the medicine is administered.
Usually, people feel pressure more than pain during the procedure. After the procedure, you can feel irritation in the eyes, watering of the eyes or feeling like there is grit in your eyes. However, the experience can be different from one person to another and it can even be quite comfortable for a lot of people.
If you are anxious, tell your retinal doctor about it before the procedure. It can help reduce your anxiety when you understand how the procedure works and all your questions are answered.
If you feel any pain or increase in pain after the procedure, you should tell your eye care professional about it right away.
What to Expect After an Intravitreal Injection
Your eyes will probably feel somewhat irritated after the treatment and your vision might be blurry for some time; the recovery process, though, will depend on the type of medicine applied and on how your body responds to the medication.
1. Mild Redness or Irritation
The most common side effect is the redness in the whites of your eye, which means that one of the tiny blood vessels in your eye was ruptured during the procedure and needs several days to recover.
Another possible side effect is the feeling of grittiness in your eye. Although this feeling eventually goes away, if it persists or gets worse you need to contact your doctor.
2. Blurred Vision
In addition, you will most likely experience blurriness of your vision for a period of time due to the preparation, the medication and the changes that took place in your eye.
Little spots and bubbles will appear before your eyes for some patients.
Please follow the instructions that you received from your clinic on driving and carrying out certain activities.
Do not drive if your vision is still blurry.
3. Photophobia
You may experience photophobia for the few days following your visit especially if your eyes were dilated. You can put on your sunglasses to ease the discomfort.
In case of severe photophobia accompanied with eye pain and vision loss, please consult your physician immediately.
4. Gradual Changes in Vision
Even though the medication will work before any changes happen to your vision, the aim of the treatment is not restoring your vision but rather keeping what you have.
Your progress during the treatment will be measured through eye tests and images. Do not measure the success of the treatment based on the state of your eye after the injection.
How to Care for Your Eyes at Home
The right aftercare will help you follow treatment and detect any potential complications. In case of any questions regarding your actions, always consult your retina specialist.
- Take Care of the Hygiene of Your Hands: Before inserting anything into or around your eye, wash your hands. Do not touch or rub the eye that was injected when it is irritated.
- Follow Eye Drops Instructions: Avoid misuse of prescribed eye drops and do not use expired medications. Do not begin antibiotic treatment without consulting with your doctor first.
- Consult About the Use of Eye Lashes and Contact Lenses: After your surgery, your clinic will suggest not using eye make-up or contact lenses for some time. Follow the recommendations given by your medical staff; they can vary.
- Go to Work Based on Your Feelings: Most people resume their daily activities after injections, but you should avoid any activities that are difficult for you due to lack of clear vision. Ask your physician about other possible limitations. Do Not Rub Your Eye or Try to Remove Bubbles from Your Vision.
- Follow-Up Visits Are Important: Your retina specialist will need to monitor the progress of your treatment through follow-up visits and decide when you should have your next injection. Don’t skip any appointments just because your vision is not changing.
What Are the Potential Risks or Side Effects?
There are several risks linked to the use of intravitreal injections, which are used for patients with different retinal diseases. Nevertheless, no medical treatment can be risk-free. It is crucial to know about all possible risks associated with intravitreal injections.
Possible risks may include:
- Eye redness and presence of a blood spot on the white surface of the eye
- Feeling of having sand in the eye
- Temporary vision blur
- Inflammation and tearing
- Injections after effects
More dangerous complications may consist of endophthalmitis, eye pressure increase, eye infection, bleeding, or retinal problems. The probability of a certain risk factor is influenced by a number of aspects including eyes’ condition and applied medicines.
The symptoms that should be considered urgent and require the doctor’s attention are:
- Increased or progressing pain in the eye
- Gradual redness
- Worsening of visual abilities
- Increasing amount of floaters and flashes
- Darkness or curtain sensation
- Increased sensitivity to light especially when it is followed by pain or vision impairment.
How Often Will You Need Retinal Injections?
This may vary according to the specific diagnosis, medications used and individual reaction. In some cases, injections are carried out according to a certain regimen which requires further adjustment. On some occasions, a long-term use of injections is required.
For example, anti-VEGF injection for macular degeneration or diabetic macular edema can involve several injections during the first stages of treatment, but their frequency may be changed later on.
The OCT scans and other results obtained during the appointment will help determine whether there is some fluid, swelling or changes in the retina. All these details will be useful in planning the future regimen for injections.
Regardless of the fact that the patient does not feel unwell, it is still important to attend all the appointments because sometimes the diseases of the retina are asymptomatic. It is better to contact the clinic regarding scheduling another appointment.
How Can You Tell if Your Treatment Is Working?
Whether or not the treatment will be effective for you would depend on your eye condition, the level of damage in your retina, and the kind of medicine that you are using. There may be those who notice improvements in their vision, while others find the reduction of swelling more beneficial.
The result of the test for your vision and the images from your retina examination will be viewed by your retina specialist. The goal is to determine if the treatment that you are receiving is controlling your disease and if the medication needs to be altered.
One other very crucial thing is informing your doctor about any new symptoms between your appointments. Sudden changes in vision must be immediately reported regardless of your regular injections.
When Should You Contact Your Retina Doctor?
The same way as you have to know about the preparation process before the treatment, it is necessary for you to know when you should contact your doctor. It is pretty normal for you to feel irritation and see a red spot after the injection; however, if you suffer from severe pain or redness, as well as see some visual disturbances, you must contact your doctor right away.
In case you experience deterioration in your condition, you have no idea about the usage of prescribed eye drops, or you would like to find out more information regarding your treatment procedure, it is time for you to contact your doctors.In case of any emergency conditions like visual problem or pain in your eye, you should schedule an appointment with your ophthalmologist.
Your retina doctor will tell you which symptoms are normal and which symptoms are signs of a potential problem.
Protecting Your Vision With Specialized Retinal Care
An intravitreal injection can be essential treatment for problems with the retina and macula. Though it may not sound familiar at first, having knowledge of what to expect in this treatment does help. Listening to your physician’s instructions, keeping your appointments, and taking notice of any abnormal symptoms can be used for your safe treatment. The treatment plan can be created by you regarding your condition and own responses, rather than using a ‘one plan for all’ approach.
Retina and Vitreous Surgeons of Utah provides retina treatment, including eye injections and treatment for conditions related to the retina. In case of doctor’s advice on an eye condition or if you need information about it, consult Utah Retina Specialists.