Eye Injections


An intravitreal injection is a procedure to place a medication directly into the space in the back of the eye called the vitreous cavity, which is filled with a jelly-like fluid called the vitreous gel. The procedure is usually performed by a trained eye specialist in the clinic.


What are intravitreal injections used for?

Intravitreal injections are used to administer medications to treat a variety of retinal conditions. Age-related macular degeneration (AMD), Diabetic retinopathy and Retinal vein occlusion are the most common conditions treated with intravitreal anti-VEGF drugs. Intravitreal steroids are used in some eyes with Diabetic retinopathy, Retinal vein occlusion and Uveitis. The anti-VEGF drugs and steroids help to reduce fluid leakage associated with these disorders. Antibiotic, antifungal and antiviral drugs are also used to treat patients with infections in the eye such as Endophthalmitis and Retinitis.


What kind of drugs can be given by intravitreal injection?

1/ Anti-VEGF medications

2/ Steroid medications

3/ Antibiotics, antiviral and antifungal medications

The injection procedure

First, the eye and eyelids are anesthetized using drops or gel so the injection doesn’t hurt. Sometimes a small numbing injection may be given.

The eye and the eyelids are then cleaned, using povidone-iodine to kill bacteria that live around the eye and to reduce the risk of infection.  An eyelid speculum is often used to keep the eyelids open during the procedure. Once the eye is prepped for injection, you will be asked to look in a particular direction depending on the location of the injection while the medicine is injected through the white part of the eye with a very small needle (Figure 1).

Patients may feel pressure, with little or no pain during the injection. The injection is over in less than 20 seconds and the entire procedure take about 10-15 minutes After the injection, the speculum is removed and the eye is cleaned. More antibiotic drops are given to further reduce the risk of infections post injections. Intraocular pressure (IOP) will be checked following the injection.


What about complications?

Severe complications are very rare with intravitreal injections.

These include:

1/ Infection in the eye or endophthalmitis

2/ Inflammation in the eye

3/ Bleeding into the vitreous gel (vitreous hemorrhage)

4/ Retinal detachment

More commonly, there may be a small bruise or subconjunctival hemorrhage (Figure 2) on the surface of the eye where the needle enters; this usually heals within a week.


What to expect after the injection?

There are usually no restrictions following the injection apart from avoiding potential contamination of the eye and not rubbing the eye. However, you may experience:

1/ Eye pain or discomfort

2/ Increased floaters in the first 1-2 days

3/ Increased sensitivity to light

4/ Decreased vision

Sometimes after an intravitreal injection, you may get a foreign body sensation in the eye. Artificial tears will be given after the injection to help ease symptoms of dryness and surface irritation.

A follow-up visit with your ophthalmologist will be scheduled according to the treatment regimen for your condition.