Intra-Ocular Injections For Age-Related Macular Degeneration

By Omar Ahmad, MD

The primary treatment option to try to preserve vision in the case of wet type macular degeneration is injection of medicine into the eye. This can be a frightening proposition for a patient.

There are several different medicines that can be injected into the eye, but they all are injected the same way. The first concept that you have to understand is that these treatments are not cures. The vast majority of patients with wet type macular degeneration need ongoing treatment. A minority of patients are able to stop getting treatment and still preserve vision. The drugs we have available to us today last between 4-8 weeks on average.

In some cases, these treatments may improve vision. But, the primary goal is to preserve the vision and to prevent further deterioration. This is why it is critical to start treatment as soon as a problem is found and to not have gaps in treatment.

Risks

The chance of serious complication after treatment is very rare (less than 1%). These complications include infection, retinal detachment and glaucoma. Less serious complications like local irritation and mild bleeding are more common, but usually resolve on their own.

The Procedure

This is not a procedure that takes place in the hospital, but rather your retina specialist's office. It is always a good idea to bring a driver with you as you may be dilated and your vision may be reduced immediately after the injection. It is also advisable not to wear eye makeup and let the technician know if you have any ocular infections or upper respiratory infection symptoms. Your eye will then be prepped with antibiotics, antiseptics and anesthetics. Commonly, a lid speculum is inserted to hold the eye open. The injection itself takes only 5-10 seconds. The speculum is removed and the eye rinsed. Some form of vision check and pressure evaluation are then performed and the procedure is complete. Most patients describe some pressure, but very little if any discomfort. There is no patch applied to the eye afterwards.

After the Procedure

Immediately after an injection, you will see floaters or black spots in your vision, which will clear within 24-48 hours. The vision may be dim or blurry for several hours after the procedure. There may also be some irritation after the procedure. Keeping the eye closed or using over-the-counter artificial tears will help lessen the symptoms. This irritation almost always resolves within 24 hours. Your eye may also be red at the injection site. This is not a complication; this is like a bruise and will resolve without treatment after several days.

Emergent issues

Danger signs to look for are significant pain in the eye, significant loss of vision, abdominal pain, headache, and light sensitivity. If there are any questions as to whether symptoms are normal or not, you should call your retina specialist immediately.