Why are eye injections given?
Increasingly, medicines are injected into the eye to treat a variety of conditions including macular degeneration, diabetic retinopathy, and retinal vein occlusion. Many different medications are injected including Lucentis, Avastin, Eylea, Beovu, Vabysmo, Syfovre, Izervay, and steroids. Especially, because these medicines may require repeated injections over time, it is essential these injections cause no pain. Therefore, we go out of our way to provide painless eye injections.
What choices of anesthesia is available?
There are currently many different ways to anesthetize the eye before an injection. Most doctors use an anesthetic eye drop. Additional local anesthesia is usually given with either a pledget, a gel, or a painless injection. A pledget is a small piece of cotton or other absorbent material that is soaked in anesthetic and placed inside the lower lid to numb the eye in preparation of an injection. Rarely, an anesthetic injection is needed. While an anesthetic injection sounds worse, it causes no pain (due to the anesthetic drops) and works better in some patients to avoid pain with the intraocular injection of medicine.
What needles are used for injecting medicine?
Fine needles are used for injection to minimize discomfort. The standard needle size for injections into the eye is 30 gauge. However, most medications may be injected with much finer 33 gauge needles. There are some medications, such as Syfovre, that require larger bore needles due to viscosity.
What are other causes of pain with eye injection?
In rare instances pain may occur due to an increase in the eye pressure. When medicine is injected into the eye it takes up space. Because the eyeball does not enlarge like a balloon, the pressure inside the eye increases. Usually, this increase in pressure is well tolerated. However, in some patients the increase in pressure may cause pain. In this situation the doctor may elect to remove a small amount of fluid from the eye before injecting the medicine in order to avoid the pressure increase and the associated pain.
Measures can be taken to avoid pain with most eye injections. Another issue is pain after an eye injection. Please see link for more information.
For a telemedicine consultation with Dr Pautler, please send email request to spautler@rvaf.com. We accept Medicare and most insurances in Florida. Please include contact information (including phone number) in the email. We are unable to provide consultation for those living outside the state of Florida with the exception of limited one-time consultations with residents of the following states: Alabama, Arkansas, Connecticut, Georgia, Minnesota, and Washington.
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