What is Intravitreal Injection ?

Intravitreal injection is the method of administration of drugs into the eye (directly into the vitreous). It is used to treat various eye diseases such as age related macular degeneration (AMD), diabetic macular edema and diabetic retinopathy, macular edema due to vein occlusions or certain ocular inflammatory conditions, and infections inside the eye (endophthalmitis). 

As compared to eye drops (topical administration) this method is beneficial for a more localized delivery of medication to the targeted site. It also minimises the adverse effects to the other body tissues caused when medications are given systemically (injections or tablets).

What are commonly used Intravitreal Injections?

  • Anti-VEGFs (Accentrix, Lucentis, Razumab, Eylea, Pagenax)
  • Steroids (Dexamethasone, Triamcinolone, Fluocinolone)
  • Anti-microbial (Antibiotics, Antifungals, Antivirals)

What are the indications of Intravitreal Injections?

Disorders or diseases that can be treated with Intravitreal Injections include:

  • Age related macular degeneration
  • Macular edema
    • Diabetic Macular Edema
    • Secondary to Vein Occlusion
    • Pseudophakic Cystoid Macular Edema
    • Uveitis related Macular Edema
  • Diabetic Retinopathy
  • Retinal Vein Occlusions
  • Non Infectious Inflammations
  • Infections
    • Endophthalmitis
    • Retinitis

What is the procedure for Intravitreal Injections?

The exact procedure and technique of Intravitreal Injection varies from one hospital to the other. At Anjani Eye Hospital, the Intravitreal Injection is done in the operation theatre (to reduce the chances of infection). 

  • Eye drops to dilate the pupil
  • Anesthetic eye drops to numb the eye 
  • Antibiotic eye drops
  • Cleaning the eye and surrounding skin to prevent infection (Your face may also be covered to keep the eye sterile)
  • A device to hold the eye open during treatment
  • An injection of anti-VEGF or steroid drugs
  • Antibiotic eye drops

What are the possible risks and complications of Intravitreal Injection?

Intravitreal Injections are relatively very safe. The side effects / risks of Intravitreal Injection can be broadly classified into drug related side effects and procedure related side effects. However, the least would be exhaustive and hence we are mentioning a few side effects / complications here.

  • Subconjunctival hemorrhage or redness
  • Irritation or discomfort of the eye
  • Pain or discharge
  • Blurred vision or changes in vision
  • Seeing “spots” in your vision
  • Bleeding in the eye  (vitreous hemorrhage), retinal detachment
  • Cataract progression / formation
  • Retinal detachment
  • Increased eye pressure (glaucoma)
  • Intraocular infection (endophthalmitis)
  • Very rarely, systemic side effects of drugs can occur. These include high blood pressure, nose and throat infection, and headache, arterial thrombo-embolic events such as TIA, heart attack and stroke.

The goal of treatment is to prevent further loss of vision. Although some patients have regained vision, the medication may not restore vision that has already lost, and may not ultimately prevent further loss of vision caused by the disease.

Frequently Asked Questions (FAQ)

Intravitreal injections are used to treat many diseases that cause irreversible vision loss. They mainly work by preventing further damage and do not help regain the lost vision. Your vision may improve slightly in some cases, but there is no guarantee.

It depends on your response to the first injection treatment. If the problem persists, then a repeat injection may be required.

Intravitreal injections are given through the white portion of the eye. You will be given anesthetic eye drops, so you should not feel any pain and the injection should not cause any problems.

There are a few, but they are very rare. Injection treatment is a very safe procedure. In fact, you can go home on the same day as the treatment.