An intravitreal injection is an in-office procedure in which a medication is injected into the vitreous cavity of the eye. This procedure is typically performed in a nearly painless manner for patients.
It is common for patients to see black spots that move when their eye moves after the procedure. This represents air within the medication.
Betadine is a topical antiseptic that is used during the procedure to decrease the risk of infection. It does not hurt at first, but can cause significant irritation after the procedure, sometimes making it difficult to open the eye. This irritation will usually resolve on its own within a day.
Redness commonly occurs after the injection where the needle entered the eye. In some cases, the entire eye will become very red. The redness will resolve on its own within 1-2 weeks and cause no permanent harm to the vision.
The eye is typically sore after the injection, but usually feels much better by the following day.
The vision is usually much blurrier after the injection due to the use of betadine. If the vision goes black immediately after the injection, this could be a sign that the eye pressure is too high. The vision will usually return on its own within a minute. However, this does require you to immediately make your doctor aware.
What can patients do to minimize discomfort following an intravitreal injection?
Request the technician rinse your eye out with eye wash thoroughly following the injection.
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.
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.
What are the risks associated with a Beovu injection?
Beovu is FDA approved for the treatment of Wet Age-related macular degeneration (AMD). The medication has been proven to be as effective and last longer than other FDA approved medications available for the treatment of wet AMD. Beovu is effective at improving and stabilizing vision in the vast majority of patients. A small minority of eye(s) (4.6%) may develop inflammation in the eye(s) treated with Beovu during the first two years of treatment. The risk of inflammation causing a significant loss of vision is approximately 7 in 1000. Your ophthalmologist has recommended Beovu because their experience suggests that the well-established benefits of Beovu outweighs the risks of using an alternative medication to Beovu.
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.
Avoid using contact lenses for 5 days following the injection.
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 or swimming for 1 week.
Patients who are at risk of debris entering the eye should use eye protection outside to decrease the risk of dust or germs getting into the eye.
Be alert for these symptoms:
Endophthalmitis is a rare sight threatening infection which can occur following 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 eye.
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.
Beovu is uncommonly associated with inflammation. Patients who notice increased light sensitivity or a decrease in their vision following Beovu injection should reach out to their ophthalmologist to discuss if prompt evaluation is needed.
Most patients undergoing intravitreal injections find that with proper anesthesia and adequate rinsing that the procedure can be quite painless.
Please contact your eye care specialist if you have additional questions or concerns.