A number of retinal diseases are treated with intravitreal injections of medication, primarily anti-VEGF agents such as Avastin (bevacizumab), Eylea (aflibercept), and Lucentis (ranibizumab) as well as steroid preparations. These diseases include macular degeneration, diabetes, vein occlusions, and uveitis. Although medication injections sound very painful, they are done after anesthetic is given and are fairly easily tolerated. Typically, they are done in the office in the exam chair with no restrictions afterwards. Multiple injections are often needed on a schedule that will be determined by the doctor, often starting monthly.
The injection itself is done with a very fine needle. First, the eye is prepared with some anesthetic and antiseptic for cleaning. A speculum is placed to hold the eye open during the procedure. The medication is injected quickly into the vitreous gel through the white part of the eye (the pars plana). The speculum is removed, and the eye is cleaned/rinsed. Many people have mild burning and irritation after the injections for several hours, but usually the eye feels normal by the next morning. Also, floaters (specks or bubbles in the vision) are common afterwards, although they often fade within the first few days. The speed of the visual response is variable – sometimes within the hour and sometimes gradually over many months.