An intravitreal injection is an in-office procedure in which a medication is injected into the vitreous cavity (back part) of the eye. This procedure is typically performed in a nearly painless manner for patients. Patients may notice black spots (floaters) that move after the procedure. This is usually from the medication, air bubble or vitreous clumps that form that typically resolve within a few days.
Betadine is a topical antiseptic that is used during the procedure to decrease the risk of infection. It can burn when applied during the procedure, and can cause irritation after the procedure once the anesthetic effect wears off. This irritation will usually resolve on its own within a day. You may use artificial tears 2-4 times daily to reduce the irritation as well. Redness can occur after the injection where the needle entered the eye from bleeding on the surface of the eye on the white part turning it red. In some cases, the entire eye will become very red. The redness will resolve on its own within 1-2 weeks and cause no permanent harm to the vision. The eye is typically sore after the injection, but usually feels much better by the following day.
The vision is can be blurry after the injection due to the use of betadine. If the vision goes black immediately after the injection, this could be a sign that the eye pressure is too high. The vision will usually return on its own within a minute or so. However, this does require immediate attention from your doctor.
What can patients do to minimize discomfort following an intravitreal injection?
If your eye has a burning sensation, then consider using preservative free artificial tears every 1 hour or 2-4 times daily as needed for discomfort (see example on the left). Be sure to wash your hands with soap and water and avoid touching your eye lashes.
Recognize the signs of endophthalmitis – endophthalmitis is a rare (1 in 2000 or less), but serious infection of the eye. It may lead to blindness if not treated emergently. It most commonly occurs 2-5 days following an injection, but may occur sooner or later. The symptoms are a combination of the following: redness around the entire eye that gets worse not better, severe worsening eye pain beyond 24 hours, increased sensitivity to light, worsening vision. This is a medical emergency and requires a call to your physician immediately. If the physician is unavailable or does not answer, go immediately to an ER that has an eye doctor on-call.
Post-injection activities:
Touching or rubbing the eye increases the risk of a scratch or eye infection. If there is an insatiable itch, it is recommended to wash your hands with soap and water prior to patting gently overlying the closed eyelid. Avoid using contact lenses for 2-3 days following the injection. Artificial tears or lubricating eye ointment may be used after the injection. Prescription eye drops (e.x for glaucoma) may also be used the same day as the injection, unless otherwise specified by your doctor.
It is recommended to avoid allowing water into the eyes or swimming for 1 week. Patients who are at risk of debris entering the eye should use eye protection outside to decrease the risk of dust or germs getting into the eye.
Most patients undergoing intravitreal injections find that with proper anesthesia, the procedure can be quite painless. Please contact your eye care specialist if you have additional questions or concerns.