Advice Following an Intra-Vitreal Injection - Ipswich Hospital

Occasionally patients require eye dropsfor a few months or longer to control theintra-ocular pressure.Outside of these hours please telephonethe hospital switchboard on 01473 712233and ask for the eye doctor on-call.Approximately 1 in 1000 peoplewill develop a serious eye infection(endophthalmitis). This is treated withintensive antibiotics, but can result inpermanent loss of vision.There is a 1% risk of developing a tearin the retina. This is treated with lasersurgery.Intra-vitreal steroids can increase thechances of the lens of the eye becomingcloudy (a cataract).After the injectionYour eye drops / ointment are / is calledPlease put into the right / left / both eyestimes a day fordays.Please wash your hands before andafter putting in your eye drops /ointment..Information for patientsAdviceFollowing anIntra-VitrealInjection• Take things easy for the rest of the day.• Your eye may be uncomfortable andyou may need to take your usual painrelief tablets.• Please use your eye drops or ointmentas prescribed.• Your vision may be misty for a fewdays. The floaters or ‘black swirls’ willgradually disperse but this can take afew weeks.If your eye becomes very painful, red oryour vision suddenly deteriorates pleasetelephone the hospital switchboard on01473 712233 and ask for the Eye Cliniccoordinator (Monday – Friday, 8.30 am to4.30 pm, or call the Ophthalmic Day CareUnit on 01473 702007 (Monday – Friday,8.00 am to 4.00 pm).Produced by:The Ipswich Hospital NHS TrustHeath Road, Ipswich, Suffolk IP4 5PDHospital switchboard: 01473 712233www.ipswichhospital.nhs.ukDMI ref: 4740-07.indd(RP)Eye ClinicTel: 01473 703230Issue 1: February 2008© The Ipswich Hospital NHS Trust, 2008. All rightsreserved. Not to be reproduced in whole, or in part,without the permission of the copyright owner.

What is an intra-vitrealinjection?An intra-vitreal injection is an injection intothe vitreous gel of the eye. These injectionsare used to administer drugs directly intothe eye. The drugs most commonly usedare anti-inflammatory agents, antibioticsand anti-vasoendothelial growth factor(anti-VEGF) agents.Route of injectionCorneaPupilIrisLensRetinaMaculaOptic nerveWhy do I need an intra-vitrealinjection?Your ophthalmologist will have explainedto you why you need to have an intravitrealinjection.Anti-inflammatory drugs (steroids) areused to reduce swelling of the retina, andthey are used in conditions such as diabeticmaculopathy, central retinal vein occlusionand macular degeneration. You shouldhave received information about your eyecondition at your clinic consultation.Anti-VEGF agents are a relatively new classof drugs used in wet (exudative) maculardegeneration to stop the growth of fragilenew vessels under the macula area of theretina. The macula is the part of the retinawhich enables you to focus your vision ondetail and perform tasks such as reading.Intra-vitreal antibiotics are used in severeeye infections, and tend to be used inemergency situations.Where does the procedure takeplace?If you are having a steroid injection this isperformed in the operating theatre in theOphthalmic Day Care Unit (ODCU). You willbe given the date, time, and directions toODCU either at your clinic visit or by letteror telephone call before your admission.If you are having an anti-VEGF agent,this procedure takes place either inODCU or the Eye Clinic. Again all relevantinformation will be given to you beforeyour appointment.What does the procedureinvolve?You will have some local anaestheticdrops put into your lower lid to numbyour eye. Then you may have either alocal anaesthetic injection or a cottonbud soaked in local anaesthetic insertedbeneath your upper lid. You will also havean antiseptic eye drop before the injectionof the drug, and the skin surrounding youreye will be cleaned with an iodine-basedantiseptic solution.The procedure only takes a few minutes,but it is important that you keep still andlie as flat as possible.During the injection your vision maysuddenly go dark for a second or two. Youwill then see some black swirls in yourvision which gradually disperse after a fewweeks.The benefits of treatmentThe aim of intra-vitreal therapy is toimprove or stabilise your vision. Theoutcome depends largely upon yourindividual eye condition.20-50% of people will notice someimprovement in vision following a steroidinjection. This improvement is oftentemporary and treatment may be offeredagain 3-6 months later.Anti-VEGF injections need to be repeatedevery 4-6 weeks (depending on which drugis used). Normally a minimum of threeinjections are given. Treatment is 90%successful in stabilising the vision.Risks of treatmentThe injection will raise the pressure withinthe eye (intra-ocular pressure) for a fewhours. This is more likely if you haveglaucoma. If the pressure remains elevatedyou will be given extra eye drops andpossibly some tablets to take at home.Ô