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Don't worry: Eye injections are a simple and safe procedure

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Eye Department
Understand that intravitreal injections are a safe, simple, and highly effective procedure. Relieve your concerns and regain your vision at University Medical Center Ho Chi Minh City.

Intravitreal injections, also known as injections into the eye, are a common and highly effective medical procedure used to treat many serious eye conditions, helping to protect and restore vision for millions of people worldwide. Although the thought of having a needle inserted into the eye may cause anxiety, the procedure is actually simple, quick, and highly safe when performed under strict medical standards. This article will help you better understand intravitreal injections, helping to ease concerns and give you greater confidence when choosing this treatment approach.

1. What are intravitreal injections?

1.1. Definition of intravitreal injections

Intravitreal injection is a procedure in which medication is injected directly into the vitreous cavity of the eye, which contains a gel-like substance called the vitreous. Direct injection allows the medication to reach the retina and structures at the back of the eye effectively, achieving a high concentration at the treatment site without requiring high systemic doses, thereby minimizing side effects [1, 3]. This is the most widely used treatment approach worldwide for retinal diseases [3].

1.2. Commonly used medications and their effects

Medications commonly administered by intravitreal injection include:

  • Anti-VEGF medications: This is the most commonly used group of medications. They work by inhibiting the growth of abnormal blood vessels in the eye and reducing retinal edema. Representative medications include Bevacizumab (Avastin), Ranibizumab (Lucentis), and Aflibercept (Eylea) [1, 3].
  • Corticosteroids: These help reduce inflammation and edema in conditions such as macular edema caused by retinal vein occlusion or uveitis. Dexamethasone (Ozurdex) is one example [4].
  • Antibiotics: These are used to treat cases of intraocular infection (endophthalmitis) [3].

2. When are intravitreal injections needed? (Indications)

2.1. Conditions for which intravitreal injections are indicated

Intravitreal injections are indicated for many serious eye conditions that may threaten vision, including [3]:

  • Wet age-related macular degeneration (wet AMD): A condition in which abnormal blood vessels develop beneath the retina, causing fluid and blood leakage and resulting in reduced central vision.
  • Diabetic macular edema (DME): A complication of diabetes that causes swelling in the macular region, affecting the ability to see clearly.
  • Retinal vein occlusion (RVO): A condition that causes macular edema and intraocular hemorrhage, leading to reduced vision.
  • Uveitis: Inflammation of the middle layers of the eye, which can cause serious damage if left untreated.
  • Pathologic myopia with choroidal neovascularization: Abnormal blood vessel growth in people with severe myopia.

2.2. Importance of timely treatment

Timely intravitreal treatment plays an extremely important role in preserving and improving vision. Many eye conditions can progress rapidly and may cause permanent vision loss if not treated early. Direct injection of medication into the eye allows the medication to act rapidly and strongly at the affected area, helping to prevent damage and optimize treatment outcomes [3].

3. How are intravitreal injections performed? (A simple procedure)

Intravitreal injections are usually performed in a sterile procedure room by an ophthalmologist who has received appropriate training. The entire procedure generally takes about 15–30 minutes [1, 3]:

3.1. Preparation before the injection

  • Eye examination and consultation: The doctor will examine your eye, assess your condition, and explain the procedure in detail, including its benefits and potential risks, so that you understand the procedure and feel reassured.
  • Disinfection and local anesthesia: Before the injection, local anesthetic eye drops will be administered to reduce discomfort and pain [1, 3]. The area around the eye and eyelids will also be carefully disinfected with 5% povidone-iodine solution to ensure sterility and prevent infection [1, 4]. A small device will be used to keep the eyelids open throughout the procedure [3].

3.2. Injection procedure

  • Sterile technique and standardized injection technique: The doctor will use sterile gloves and strictly follow aseptic procedures. A very fine needle, typically a 30-gauge needle, is inserted into the eye through the sclera, approximately 3.5–4 mm from the corneal limbus [1, 3]. The medication is then injected into the vitreous cavity. The injection itself is very quick, usually taking only a few seconds [1].
  • Quick procedure: Thanks to modern techniques and the physician's expertise, the injection itself takes only a few minutes [1]. You may feel slight pressure or a sensation of fullness, but it should not be painful [3].

3.3. Post-injection care

  • Monitoring and home care: After the injection, the doctor may administer antibiotic eye drops. You may experience mild grittiness, discomfort, or tearing during the first few hours. Some people may notice a small red spot on the white part of the eye (subconjunctival hemorrhage), which is normal and will resolve on its own within a few days. Avoid rubbing your eyes during the first few days and use eye drops as prescribed by your doctor.
  • Follow-up schedule: The doctor will schedule follow-up visits to examine your eyes, assess treatment effectiveness, and monitor for any abnormal signs.

4. Benefits of intravitreal injections

4.1. Improving and protecting vision

Intravitreal injections have revolutionized the treatment of many retinal diseases, helping millions of patients achieve significant improvements in vision and quality of life [3]. By delivering medication directly to the affected area, this procedure provides high treatment efficacy in reducing edema, inhibiting abnormal blood vessel growth, and controlling disease progression [3].

4.2. Preventing serious complications

Intravitreal treatment helps prevent serious complications that may lead to permanent vision loss, such as retinal hemorrhage, retinal detachment, or irreversible macular damage.

5. Are intravitreal injections safe? (Risks and complications)

Intravitreal injections are considered a very safe procedure [3]. However, as with any medical intervention, there are still some risks and complications, although they occur at very low rates.

5.1. Very low complication rates

The most serious complication is intraocular infection (endophthalmitis), but this is extremely rare, with an estimated incidence of only approximately 0.02% to 0.085% per injection [1, 3]. Other complications may occur but are also rare and are usually mild, including:

  • Temporary increase in intraocular pressure [1].
  • Subconjunctival hemorrhage (a red spot on the white part of the eye that usually resolves on its own) [3].
  • Mild inflammation or temporary discomfort [3].
  • Retinal detachment or corneal injury (very rare) [3].

5.2. Measures to prevent complications

To ensure maximum safety and minimize risks, reputable healthcare facilities strictly adhere to the following measures [1, 4]:

  • Strict aseptic procedures: The procedure room, instruments, and injection site are thoroughly disinfected.
  • Use of povidone-iodine: 5% povidone-iodine solution is used to clean the eye and surrounding area, which is a key measure for preventing infection [1].
  • Precise injection technique: The procedure is performed by a qualified physician who ensures accurate injection placement and technique.
  • Close monitoring: Patients are carefully monitored after the injection so that any abnormal signs, if present, can be detected and managed promptly.

6. Frequently asked questions (FAQ)

  • Is an intravitreal injection painful? Thanks to local anesthesia, you will generally feel only slight pressure or a sensation of fullness, without pain during the injection. Many patients who undergo repeated injections also report that their anxiety decreases over time [5, 6].
  • Do I need to make any special preparations before the injection? You should inform your doctor about your medical history, medications you are taking, and any allergies. Your doctor will provide specific instructions on what to do before the injection, such as avoiding eye makeup.
  • Can I see immediately after the injection? Your vision may be slightly blurred or you may feel as though there is a foreign body in your eye immediately after the injection due to the medication or a small amount of air. However, these sensations usually resolve quickly, and your vision will gradually stabilize.
  • How many injections will I need, and for how long? The number and frequency of injections depend on your condition, the medication used, and your individual treatment response. Your doctor will develop an appropriate treatment regimen for you.
  • Are there any side effects I should watch for after the injection? Common side effects are usually mild and temporary, such as eye redness, grittiness, or seeing “floaters.” You should contact your doctor immediately if you experience severe eye pain, sudden vision loss, marked eye redness, or sensitivity to light [3].

7. References

The information above is for reference purposes only and is not intended as medical advice. Please contact your doctor for detailed medical consultation.

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