Intravitreal injection

Definition

An intravitreal injection is a shot of medicine into the eye. The inside of the eye is filled with a jelly-like fluid (vitreous). During this procedure, your health care provider (usually an ophthalmologist) injects medicine into the vitreous, near the retina at the back of the eye. The medicine can treat certain eye problems and help protect your vision. This method is most often used to get a higher level of medicine to the retina.

Alternative Names

Antibiotic - intravitreal injection; Triamcinolone - intravitreal injection; Dexamethasone - intravitreal injection; Lucentis - intravitreal injection; Avastin - intravitreal injection; Bevacizumab - intravitreal injection; Ranibizumab - intravitreal injection; Anti-VEGF medicines - intravitreal injection; Macular edema - intravitreal injection; Retinopathy - intravitreal injection; Retinal vein occlusion - intravitreal injection

Description

The procedure is done in your provider's office. It takes about 15 to 30 minutes.

  • Drops will be placed in your eyes to widen (dilate) the pupils.
  • You will lie face up in a comfortable position.
  • Your eyes and eyelids will be cleaned.
  • Numbing drops will be placed in your eye.
  • A small device will keep your eyelids open during the procedure.
  • You will be asked to look toward the other eye.
  • Medicine will be injected into your eye with a small needle. You may feel pressure, but not pain.
  • Antibiotic drops may be placed in your eye.

Why the Procedure Is Performed

You may have this procedure if you have:

  • Macular degeneration -- an eye disorder that slowly destroys sharp, central vision
  • Macular edema -- swelling or thickening of the macula, the part of your eye that provides sharp, central vision
  • Diabetic retinopathy -- a complication of diabetes, which can cause new, abnormal blood vessels to grow in the retina, the back part of your eye
  • Uveitis -- swelling and inflammation within the eyeball
  • Retinal vein occlusion -- a blockage of the veins that carry blood away from the retina and out of the eye
  • Endophthalmitis -- infection in the inside of the eye

Sometimes, an intravitreal injection of antibiotics and steroids is given as part of routine cataract surgery. This avoids having to use drops after surgery.

Risks

Side effects are rare, and many can be managed. They may include:

  • Increased pressure in the eye
  • Floaters
  • Inflammation
  • Bleeding
  • Scratched cornea
  • Damage to the retina or surrounding nerves or structures
  • Infection
  • Vision loss
  • Loss of the eye (very rare)
  • Side effects from the medicines that are used

Discuss the risks for specific medicines used in your eye with your provider.

Before the Procedure

Tell your provider about:

  • Any health problems
  • Medicines you take, including any over-the-counter medicines
  • Any allergies
  • Any bleeding tendencies

After the Procedure

Following the procedure:

  • You may feel a few sensations in the eye such as pressure and grittiness, but there should not be pain.
  • There may be a little bleeding on the white of the eye. This is normal and will go away.
  • You may see eye floaters in your vision. They will improve over time.
  • DO NOT rub your eyes for several days.
  • Avoid swimming for at least 3 days.
  • Use eye drops as directed.

Report any eye pain or discomfort, redness, sensitivity to light, or changes in your vision to your provider right away.

Schedule a follow-up appointment with your provider as directed.

Outlook (Prognosis)

Your outlook depends mostly on the condition being treated. Your vision may remain stable or improve after the procedure. You may need more than one injection.

References

American Academy of Ophthalmology website. Age-related macular degeneration PPP 2019. www.aao.org/preferred-practice-pattern/age-related-macular-degeneration-ppp. Updated March 2022. Accessed February 6, 2023.

Kim JW, Berry JL, Murphree AL. Retinoblastoma. In: Sadda SVR, Sarraf D, Freund KB, et al, eds. Ryan's Retina. 7th ed. Philadelphia, PA: Elsevier; 2023:chap 129.

Rodger DC, Shildkrot YE, Eliott D. Infectious endophthalmitis. In: Yanoff M, Duker JS, eds. Ophthalmology. 6th ed. Philadelphia, PA: Elsevier; 2023:chap 7.8.

Shultz RW, Maloney MH, Bakri SJ. Intravitreal injections and medication implants. In: Yanoff M, Duker JS, eds. Ophthalmology. 6th ed. Philadelphia, PA: Elsevier; 2023:chap 6.11.

Review Date: 11/10/2022
Reviewed By: Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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