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An eye injection (also called an intravitreal injection or IVI) is a procedure where medication is injected inside the eye into the vitreous. The vitreous is the jelly-like substance that fills the inside of your eye.
Eye injections are most commonly used to treat retinal and macular conditions such as wet macular degeneration (also known as age-related macular degeneration or AMD), diabetic retinopathy, diabetic eye disease and retinal vein occlusion. These conditions may require a long-term course of intravitreal injections to stop any swelling and bleeding. These injections aim to prevent, and potentially reverse, vision loss.
Intravitreal injections are not used to treat Stargardt disease (juvenile macular degeneration) but are sometimes used to treat ocular inflammation.
If the thought of having an eye injection is frightening, knowing and understanding what will happen can help enormously. It’s important to continue with treatment as long as your doctor recommends it. Stopping treatment early can put your sight at risk.
You will be called from the waiting room by an orthoptist – an orthoptist is a university-trained technician who assists the ophthalmologist (eye specialist or eye doctor) by performing diagnostic eye tests. The orthoptist will check your vision and take an OCT scan of your eye to obtain high-quality images of the retina and macula.
OCT scans help your doctor monitor how your eye is responding to the injections.
The orthoptist will apply anaesthetic eye drops (or gel) and also clean your eye with antiseptic so your eye will be numb and sterile when it is time to have the injection.
Your ophthalmologist will review the results of your eye tests and OCT scan and discuss these with you before performing the eye injection.
While sitting in a chair or lying on a trolley, you will be asked to look at a specially marked target, usually on the ceiling – this helps you stay focused and keep your eye steady. The doctor will gently hold your eyelids open using their fingers and perform the injection quickly using a tiny needle.
After the injection, the doctor will examine your eye and apply a lubricating gel. You may be asked to use the gel for the next day or two to help lubricate the eye and reduce any gritty sensation.
You will not be able to drive yourself home after your procedure – it’s best not to drive for a few hours afterwards. You can have a family member or friend drive you home, or you can catch a taxi.
Please make sure the car windows are shut and don’t let the fan blow on your eyes. Your eye will still be a little numb, which makes it more prone to drying out. The best thing to do is to keep your eyes closed for a couple of hours after the injection.
Your eye might feel a bit uncomfortable once the anaesthetic wears off. Over-the-counter pain relief (e.g. paracetamol) can be taken if necessary. If your vision becomes worse or your eye becomes more painful, contact your ophthalmologist or their clinic immediately. DO NOT WAIT until the next day or a convenient time.
Injections into the eye are not painful because your eye will feel numb from the anaesthetic drops administered by the orthoptist. However, you may feel a bit of discomfort – most patients describe feeling slight pressure on their eye.
There is a low risk of serious complications caused by eye injections (around 1 in 1000 or less).1 These are retinal detachment and endophthalmitis (inflammation inside the eye).
Symptoms of retinal detachment include floating spots or lines and flashes of light, blurry vision, gradually diminishing side vision and a curtain-like shadow coming down over your visual field.
Symptoms of endophthalmitis include increasing or severe eye pain, increasing redness of your eye, worsening vision, headache and eyelid swelling.
No, you will need to have someone else drive you home after your eye injection. It is best if you keep your eyes closed for a couple of hours after the injection to stop them from drying out and feeling uncomfortable.
If your ophthalmologist has determined that eye injections are the best treatment for your condition, it is important to continue with them as often as recommended. Stopping treatment against the advice of your ophthalmologist could put your sight at risk.
In some situations, treatment with eye injections will restore some vision. Your ophthalmologist will be able to provide more specific advice.
This depends on your particular condition and how you respond to treatment. If your eye is responding well, your ophthalmologist may try to extend the interval between injections.
1. RANZCO Guidelines for Performing Intravitreal Therapy. Available at https://bit.ly/2WRVExO (accessed online November 2019).
IMPORTANT: If you are concerned about your eyes and require an urgent consultation, DO NOT use this form. Please call one of our clinics during office hours or contact your nearest emergency department.