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OUTLOOK EYE TREATMENTS

Intravitreal Injections

Intravitreal injection of a drug is a very common and effective treatment option for a number of eye conditions, including wet age-related macular degeneration (AMD), retinal vein occlusions and diabetic retinopathy. These treatments have been a minor miracle in improving the outlook for patients with these conditions, particularly when the problem is caught early. They are very effective at preventing further vision loss and the vision improves in a significant proportion of patients.

The injection is always done with anaesthesia to make the process as comfortable as possible. The anaesthesia is typically in the form of eyedrops, gel, or occasionally a small injection under the conjunctiva. The injection is performed under sterile conditions and is delivered into the vitreous cavity of the eye. As the injection is done from the side, it is typically not seen by the patient. The whole procedure is most often painless, but there can be some mild discomfort during it and for a few hours after. There is commonly a floater in the vision for a day or two after the injection, which is the drug inside the eye, or occasionally some tiny air bubbles. This is not a problem.

Like all drugs, the effect wears off over time and hence it is very common to need repeat intravitreal injections. The most common drugs that are used for intravitreal injection are Lucentis, Eylea, Beovu, Avastin, Triamcinolone, and Ozurdex.

Introduction:

Intravitreal injections occur when drugs are injected into the cavity of the eye. They are a very common form of treatment for retinal problems like macular degeneration, diabetic eye disease and vein occlusions.

Procedure:

  1. The eye is anaesthetised.
  2. The eye is cleaned with antiseptic.
  3. A speculum is used to keep your lids apart.
  4. The drug is injected into the eye.

This process usually takes less than 5 minutes.

After the procedure:

* Patients often experience some grittiness for 1-2 days. This is the result of the anaesthetic and antiseptic. You may use some lubricant drops for this, but it is best not to touch the eye if possible.

* Redness: Occasionally a vessel on the white part of the eye (sclera) bleeds. This leads to a “subconjunctival haemorrhage”. This is like bruising of the eye. It will resolve over the next 1-2 weeks with no problems.

* Specks in the Vision
This represents air bubbles in the medicine. They are quite common and will disappear in 1-2 days.

Complications:

The likelihood of these occurring are very low. They include:

  1. Infection (which usually presents a few days after an injection
  2. Internal bleeding (which typically resolves spontaneously)
  3. Retinal detachment

If you suspect a serious problem, please advise your doctor ASAP. If you are unable to contact your doctor or the Outlook office, it is best to make your way to the Emergency Department at Gold Coast University Hospital for assessment by an Ophthalmology Registrar. (Private hospitals do not have an Emergency Ophthalmology service).

Helpful links: YAG Laser Capsulotomy, Laser Retinopexy, SLT Laser, Corneal Collagen Cross Linking, Intense Pulse Light

Frequently Asked Questions

An intravitreal injection is the delivery of medication directly into the vitreous cavity, the gel-filled space inside the eye. It is the most effective way to deliver drugs to the retina and macula, as eye drops and oral medications cannot reach the back of the eye in therapeutic concentrations.
The eye is thoroughly numbed with anaesthetic drops before the injection, so most patients feel only mild pressure or a brief stinging sensation. The procedure is generally well tolerated. Some patients notice floaters or mild discomfort for 24–48 hours afterward, which settles on its own.
The injection itself takes only a few seconds. Including preparation, anaesthetic, and post-injection eye pressure check, you should expect to be at the clinic for approximately 30–45 minutes.
The number of injections required varies depending on the condition being treated and your response to treatment. Wet macular degeneration typically requires monthly injections initially, transitioning to a treat-and-extend regime. Your ophthalmologist will review your OCT imaging at each visit and adjust the treatment frequency accordingly.
Intravitreal injections are used to treat wet age-related macular degeneration (AMD), diabetic macular oedema, retinal vein occlusion with macular oedema, and myopic choroidal neovascularisation. The specific medication used depends on the condition being treated.
Serious complications are rare. The most significant risk is endophthalmitis (infection inside the eye), which occurs in approximately 1 in 2,000 injections. Other rare risks include retinal detachment and raised eye pressure. Minor side effects such as subconjunctival haemorrhage (a red patch on the white of the eye), floaters, and mild discomfort are common and self-limiting.
This depends on whether dilating drops are used at your appointment. If dilation is required, you will not be safe to drive for approximately 2 hours after the drops are instilled. We recommend arranging a driver for your injection appointments, particularly for your first few visits.
Yes. Intravitreal injections attract a Medicare rebate when performed by a specialist ophthalmologist with a valid referral. Some of the medications used (such as Eylea and Lucentis) are subsidised through the Pharmaceutical Benefits Scheme (PBS) for approved indications, significantly reducing out-of-pocket costs. Your ophthalmologist will discuss costs at your consultation.
Seek urgent review if you notice any sudden loss of vision, increasing pain, increasing redness, or the appearance of pus after an injection. These may be early signs of endophthalmitis and require same-day assessment. Mild redness, floaters, and grittiness are normal and do not require urgent review.
For wet AMD and diabetic macular oedema, ongoing treatment is usually required for many years, though the interval between injections can often be extended as the condition stabilises. A small proportion of patients achieve sustained remission and can safely pause treatment under close monitoring. Your ophthalmologist will discuss your individual prognosis at each review.