What are intravitreal eye injections?
Insight Eye Surgery provides patients with eye injections that involve injecting targeted treatments into the eye. The 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. The injections work by reducing fluid leakage from blood vessels around the macula (the part of the eye responsible for central vision) with the aim of preventing, and potentially reversing, vision loss.
What would I need these injections for?
You can have early signs of macular disease without knowing it. However, when symptoms do appear, they can include:
- difficulty with reading or any other activity which requires detailed central vision (despite wearing appropriate glasses)
- distortion, where straight lines may appear wavy or bent
- problems distinguishing faces
- dark patches in the central vision.
If you notice any of these symptoms, you should consult an eye health professional. Early detection and prompt intervention are crucial to saving sight.
The thought of having an eye injection can be concerning but by knowing and understanding what will happen can help enormously. It’s important to continue with treatment as long as your ophthalmologist recommends it. Stopping treatment early can put your sight at risk.
Intravitreal eye injections are a procedure performed in the eye clinic to deliver medication into the vitreous cavity. The drugs that are most commonly given include anti-vascular endothelial growth factor agents (Eylea®, Lucentis ®), and corticosteroids. These medications treat retinal swelling and bleeding caused by macular degeneration, retinal vein occlusions, and diabetic retinopathy:
Neovascular (Wet) age-related macular degeneration (nAMD) is a serious eye disease that can cause rapid vision loss. It occurs when abnormal blood vessels behind the retina begin to grow underneath the macula. These new blood vessels are weak and leak fluid and blood, damaging the macula and leading to vision loss.
Common symptoms of AMD include:
- Dark, empty area in the centre of vision
- Colours seeming less bright
- Things appearing as the wrong shape or size
- Blurry or distorted vision – such as straight lines appearing wavy
Diabetic macular oedema (DMO) is a common cause of vision loss in people living with diabetes. Early DMO often presents with no symptoms but can cause progressive damage to your macular before you even notice any changes to your vision. DMO is a complication of diabetic retinopathy. It occurs when damaged blood vessels leak fluid into the eye, causing swelling at the macula and vision loss.
Common symptoms of DMO include:
- Gaps or dark spots in your vision
- Muted colours
- Blurred vision
- Things appearing as the wrong shape
- Abnormal sensitivity to light
Branch retinal vein occlusion (BRVO) is caused by obstruction of a tributary (branch) of the retinal vein. This vein drains blood away from the retina, the light-sensitive layer at the back of the eye.
Common symptoms of BRVO include:
- Blurred vision
- Vision loss in one part of your field of view
- Floaters in your field of view
Central retinal vein occlusion (CRVO) is caused by obstruction of the central retinal vein. Because the main vein in the eye is blocked, the entire retina is affected.
Common symptoms of CRVO include:
- Blurry vision
- Sudden vision loss in one eye
- Floaters in your field of view
- Pain in affected eye (less common)
How often will I need the treatment?
The injections suppress the leakage for a period of time – they do not cure the condition entirely. Due to this, a course of injections is required. At the start of treatment, usually one injection per month is needed. It is important to attend all appointments while receiving injection therapy as this treatment will not work if you do not have the injection at a regular interval.
The length of time between injections, and how long you will need to stay on injection therapy will depend on the condition being treated, and how you respond to the treatment.
Are there any side effects?
Many people have no side effects at all. Common side effects of intravitreal injections include:
- Redness in the area of the eye that was injected.
- A sore or gritty sensation for one to two days. The lubricating drops will help to relieve this temporary discomfort.
- Small round floating objects in your vision. These are air bubbles from the injection, and are harmless; they will disappear after a day.
- An increase in eye pressure after injection therapy. This can be treated with eye drops or tablets
Are there more serious side effects?
Serious side effects of injection therapy are uncommon. They include bleeding or inflammation in the eye, subconjunctival haemorrhage, cataract, retinal detachment, infections inside the eye, and very rarely permanent loss of vision. These happen in less than one in 1,000 people. There is a very small increased risk of strokes and heart attacks – you should discuss the injections with your GP or cardiologist if you have had a stroke or heart attack in the previous three months.
Frequently asked questions about intravitreal injections
The eye injection will take place in the clinic – there is no need to be admitted into hospital. Before the injection you will usually have your vision and eye pressure checked, and then specialist imaging (pictures) taken of your eyes.
You will be made comfortable in a reclined position for the injection. Numbing drops will be placed on your eye. The ophthalmologist will clean around your eye. More numbing drops will be placed in your eye at this point. You will be asked to look up or down to measure the area to be injected.
The treatment is injected with a fine needle and takes only a few seconds. During the injection you may feel a pressure sensation. After the injection some lubricating drops are instilled.
The injection itself takes a couple of minutes. The whole consult including the specialist imaging usually takes about 40-60 minutes. Your vision will be a little blurry for the rest of the day.
After injection therapy, you will be given lubricating drops for eye comfort. Use these at least every two hours in the daytime for the first day or two, and then use as needed.
In the minutes leading up to your injection, approximately 5-6 anaesthetic drops will be placed into your eye. This ensures that they do not hurt - the most you will feel during the procedure is a sensation of increased pressure in your eye.
Important things to remember
It is recommended that you do not drive immediately after the treatment and instead have someone pick you up from the clinic.
Things to look out for:
If your eye becomes progressively more red and painful, or if your vision gets worse after injection therapy, this might indicate infection and normally occurs 5–7 days after the injection. Contact Dr Adams at Insight Eye Surgery on 07 3154 1515 (Brisbane) or 07 5345 5011 (Noosa) in business hours or attend your local hospital emergency department after hours.
Make an Appointment
To make a booking for a consultation or procedure, contact us here >>.
Please have on hand your:
- Medicare card number
- Health fund details (if applicable)
- DVA/Pension/health care card details (if applicable)
- Current referral letter
Further reading
There's lots of information available out there about Eye Injection Treatments. We've made it easier for you by collating it into our own info sheet for download.
Download the info sheet: Injection therapy (intra-vitreal injections) (PDF 655kb)
The Australian Macular Disease Foundation is also an excellent source of information about retinal diseases. Click here >> https://www.mdfoundation.com.au/
