Intraocular Injection is one of the treatment methods for retinal diseases (Intravitreous Injection). It can be used to treat various conditions such as abnormal blood vessels in the eye, macular edema, diabetic retinopathy, or retinal vein occlusion, etc. The injection works by inhibiting the growth of abnormal blood vessels, reducing retinal swelling, and helping to improve visual acuity.
Patient Preparation Before Starting Intraocular Injection
Before starting the injection procedure, the staff will prepare the patient by having them lie flat on the bed and instill anesthetic eye drops (0.5% tetracaine Eye drop). Bevacizumab and Ranibizumab are anti-vascular endothelial growth factor (anti-VEGF) drugs that cause the disappearance of new blood vessels, reduce inflammation, and decrease swelling of the retina and macula. These drugs have been used for intraocular injections to treat various eye diseases including age-related macular degeneration, diabetic macular edema, macular edema in retinal vein occlusion, and retinopathy of prematurity, among others.
Steps for Intraocular Injection
- Clean the area around the eye to be injected with alcohol swabs and irrigate the eye with Betadine solution.
- Inject the drug into the eye by injecting into the conjunctiva of the eye. Insert a wire retractor (eyelid speculum) to open the upper and lower eyelids.
- Perform anterior chamber paracentesis by withdrawing aqueous humor from the anterior chamber according to the volume of the injected drug to reduce intraocular pressure. After fluid withdrawal, press with a sterile cotton swab for about 30 seconds.
- Instill antibiotic eye drops such as tobrex or Poly-oph Eye drop to prevent infection.
- Cover the eye with an eye pad if there is bleeding. Some cases may not require covering, and provide cotton or gauze to absorb tears. If abnormalities occur such as severe eye pain or excessive bleeding, see a doctor before the scheduled appointment. The doctor will schedule a follow-up appointment in about 6 weeks to monitor treatment by dilating the pupil and examining the eye with a computerized device again.
Possible Side Effects After Intravitreous Injection
- Decreased vision; patients may experience blurred vision from the injected drug.
- Eye pain.
- Photophobia or sensitivity to bright light.
- Seeing black spots or floaters resembling mosquitoes or larvae drifting in the visual field.
- Red eye due to infection or subconjunctival hemorrhage (avoid water contact for 1 week after injection and use antibiotic drops for 1 week).
Complications of Intraocular Injection (Anti-VEGF Intravitreous)
- There is up to a 1% chance of eye infection after injection, which can lead to vision loss.
- There is a 2.2% chance of myocardial infarction (acute heart attack) which can cause heart failure.
- There is a 3.8% chance of stroke in people without underlying diseases. However, in those with underlying diseases or a history of stroke, the chance of recurrent stroke is up to 10%. If untreated, this condition can severely impair vision. Using intraocular injections can significantly improve or slow down vision loss.
Self-Care After Intraocular Injection
- Avoid dust and water contact with the eye for about 1 week.
- Use antibiotic eye drops as prescribed to reduce the risk of eye infection.
- Avoid contact sports or activities with impact for 1 month.
- Get plenty of rest and use your eyes only as necessary.
- Attend all follow-up appointments for the best treatment outcomes.
