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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 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.

  • Alternative Names
    • Retinal vein occlusion-intravitreal injection; Triamcinolone-intravitreal injection; Dexamethasone-intravitreal injection; Lucentis-intravitreal injection; Avastin-intravitreal injection; Bevacizumab-intravitreal injection; Ranibizumab-intravitreal injection; Anti-VEGF medications-intravitreal injection

  • Description
    • The procedure is done in your health care 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, which can cause new, abnormal blood vessels to grow in the retina, the back part of your eye
      • Swelling and inflammation within the eyeball (uveitis)
      • Retinal vein occlusion: A blockage of the veins that carry blood away from the retina and out of the eye
      • Infections in the inside of the eye (endophthalmitis)
  • Risks
    • Side effects are rare, and many can be managed. They may include:

      • Increased pressure in the eye
      • Inflammation
      • Bleeding
      • 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 of 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
      • You may feel a few sensations in the eye such as pressure and grittiness, but there should not be pain.
      • Sometimes a little bleeding can occur 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 drop medicine 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 vision may remain stable or improve after the procedure. You may need more than one injection.

  • References
    • American Academy of Ophthalmology. How to give intravitreal injections. 2013. Accessed Oct. 6, 2014.

      American Academy of Ophthalmology Retina/Vitreous Panel. Preferred Practice Pattern Guidelines. Age-Related Macular Degeneration. San Francisco, CA: American Academy of Ophthalmology; 2014. Available at: Accessed August 29, 2013.

      Mitchell P, Wong TY, Diabetic Macular Edema Treatment Guideline Working Group. Management paradigms for diabetic macular edema. Am J Ophthalmol. 2014 Mar;157(3):505-13.e1-8. PMID: 24269850

      Peyman GA, Lad EM, Moshfeghi DM. Intravitreal injection of therapeutic agents. Retina. 2009;29(7):875-912.PMID: 19584648

      Sanborn GE, Magargal LE. Venous Occusive Disease of the Retina. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology. 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 3;chap 15.