INTRAVITREAL INJECTION (FOR AMD, DIABETIC MACULAR OEDEMA, RETINAL VEIN OCCLUSION)

What is an intravitreal Injection?

An intravitreal injection is an injection into the vitreous which is the jelly like substance inside your eye.

Why is an intravitreal injection performed?

Intravitreal injections are used to deliver drugs to the retina and other structures in the back of the eye.

Common conditions treated with intravitreal injections include diabetic retinopathy, macular degeneration, retinal vascular diseases and ocular inflammation.

These conditions often require a course of repeated intravitreal injections.

What is the intravitreal injection procedure?

We will lie you in a comfortable position. Anaesthetic (numbing) drops will be placed in your eye, and your eye will be cleaned with an antiseptic solution. This may initially cause a stinging feeling. The eye is usually held open with an instrument (speculum). The medicine is then injected into your vitreous: you may feel slight pressure and a momentary sharp feeling on the eye when this is done. After the injection procedure, the doctor will check your eye and your eye may be covered with an eye pad.

What are the side effects?

After the injection you may have a gritty feeling in the eye, and the eye may look bloodshot. This will usually resolve over a few days. You may see floaters which will become smaller and disappear over one to two weeks. Sometimes you may see round floaters which are tiny bubbles of air ‐ these are harmless, and will be absorbed by the eye within 1‐2 days.

Are there any risks?

Injecting any medication into the eye may result in increased pressure within the eye, inflammation, or more serious side effects such as cataract formation, bleeding within the eye, damage to the retina (retinal detachment or tear) or other eye structures.

These side effects are rare, estimated at less than 1 per 1000 injections. It is possible that you may get an infection within your eye (endophthalmitis) as a result of the intravitreal injection. The chance of an infection is low (estimated at less than 1 per 1000 injections). An infection may lead to vision loss or, in rare cases, loss of the eye.

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Preparation for the injection:

It is very important for you to tell us about any health conditions that you have, all the medications that you are taking, and especially any allergies to medications that you have had in the past. You will be asked to sign this form on the day of your appointment.

What should I expect after the injection?

You may notice any of the following over the next two days:

- Grittiness / feeling of something in the eye: this can be quite severe in the first few hours after the treatment, but should settle down after that

- Redness of the eye, especially in the area where the injection was given. Occasionally there will be a large red spot on the white of the eye. This should be painless and the vision will not be affected. It will gradually disappear.

- Blurry vision

- Floaters or “blobs” in your vision: these will become smaller and disappear over a few days. If you have had an injection of triamcinolone, the floaters may persist for a longer time. Check this with your doctor.

- You will be given an appointment for your next checkup, and next injection if necessary, at the reception desk before leaving.

What should I look out for?

- Severe pain

- Marked worsening of vision or loss of vision

- Floaters/clouds in the vision which are new or increasing in the days after injection

If you notice any of these symptoms you must notify our eye clinic urgently, or if afterhours or during public holidays you may contact Royal Victorian Eye and Ear Hospital on (03) 9929 8666.

This information page is adapted from intravitreal injection information sheet provided by Royal Australian and New Zealand College of Ophthalmologists