Intravitreal Injections What You Need to Know

What is an Intravitreal Injection?

An Intravitreal injection is an injection into the vitreous cavity of the eye. It is an in-office procedure administered with the patient looking away from the needle. With proper anesthesia, the patient does not see or feel the needle.


Patients may see a few black spots in the bottom of their vision. This is air within the medication. It causes no harm and resolves within 24 hours.


Betadine is an anti-septic used to decrease your risk of infection. It may be very irritating to the eye and cause a burning sensation or make it difficult to open the eye. See the next section for more information.


It is common for the injection to cause a small bleed on the outside of the eye. This may cause part or the entire eye to be extremely red, like a tomato. It resolves over 1-2 weeks, like a bruise elsewhere on the body. It requires no treatment and causes no harm to the vision.


The eye is typically sore after the injection. The discomfort should be nearly completely resolved by the next morning. Pain that lasts more than 24 hours could be a sign of a scratch on the eye or an infection and requires evaluation by your doctor promptly.

Blurry Vision

The vision may be a little more blurry after the injection due to the use of betadine. If the vision goes black immediately after the injection, this is a sign that the eye pressure is too high. This requires immediate attention from your doctor.

Minimizing Pain Following an Intravitreal Injection

Step 1) Request the technician rinse your eye out with eye wash thoroughly following the injection.

Step 2) If your eye has a burning sensation, then consider using preservative free artificial tears every 1 hour as needed for discomfort (see example on the left). Be sure to wash your hands with soap and water and avoid touching your eye lashes.

Step 3) If you are unable to open your eye, this may be the sign of a corneal abrasion. It is recommended you call your physician. They will likely prescribe an antibiotic ointment to be used. The scratch resolves within 24-36 hours, without causing any permanent vision loss.

Step 4) Recognize the signs of endophthalmitis – endophthalmitis is a rare, but serious infection of the eye. It may lead to blindness if not treated emergently. It most commonly occurs 3-5 days following an injection, but may occur sooner or later. The signs are a combination of the three following findings: redness around the entire eye that gets worse not better, severe eye pain, and extreme sensitivity to light. This is a medical emergency and requires a call to your physician immediately. If the physician is unavailable or does not answer, go immediately to an ER that has an eye doctor on-call.

Post-Injection Activity

Rubbing the eye

Touching or rubbing the eye increases the risk of a scratch or eye infection. If there is an insatiable itch, it is recommended to wash your hands with soap and water prior to patting gently overlying the closed eyelid.

Contact lenses

Avoid using contact lenses for 5 days following the injection.

Eye drops

Artificial tears or lubricating eye ointment may be used after the injection. Prescription eye drops (e.x for glaucoma) may also be used the same day as the injection, unless otherwise specified by your doctor.


It is recommended to avoid allowing water into the eyes for 1 day. Avoid swimming for 1 week.

Eye protection

It is recommended to use eye protection outside to decrease the risk of dust or germs getting into the eye.

endophthalmitis - the most serious complication

Endophthalmitis is a rare site threatening complication of an intravitreal injection. It occurs in approximately 1 of every 3,000 injections. There is excellent treatment, but treatment must be administered emergently.

If endophthalmitis is going to occur, it typically occurs 3-5 days following the injection. The signs include the following 3 symptoms (patients nearly always have all three).

  1. Severe pain in or around the eyeΒ 
  2. Extreme sensitivity to light
  3. New floaters or decreased vision

Endophthalmitis should be treated emergently. Call your doctor immediately if you are experiencing such symptoms.

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