Precision treatment for diseases of central vision
Intravitreal injection is now the mainstay treatment for age-related macular degeneration (AMD), diabetic macular edema (DME), and retinal vein occlusion (RVO). Each session takes a few minutes in a sterile environment.
When are intravitreal injections used?
1) Age-related macular degeneration (Wet AMD)
A disease of the central retina in older adults, causing distortion of straight lines and a central blind spot. The wet form of AMD responds well to Anti-VEGF injections.
2) Diabetic macular edema (DME)
Fluid accumulation at the centre of the retina caused by long-standing hyperglycemia. Injection therapy reduces the edema and improves vision in most cases.
3) Retinal vein occlusion (RVO)
A sudden blockage in one of the retinal veins causing bleeding and edema. Injection reduces the edema and improves vision; adjunctive laser is used in selected cases.
4) Other conditions
- Myopic choroidal neovascularization.
- Selected hereditary or inflammatory retinal diseases (after individual evaluation).
How an injection session is performed
- Sterilization: Full sterilization of the eye and surrounding area — the session is performed in a sterile, theatre-like environment.
- Anesthesia: Topical anesthetic drops only.
- Injection: A very fine needle enters through the white of the eye into the vitreous cavity — the actual injection takes only seconds.
- After the injection: Antibiotic drops for a few days, with a quick return to normal activity.
Injection protocol
Treatment usually begins with three monthly loading doses, then the schedule is tailored to the eye's response:
- Treat & Extend: gradually lengthening the interval between injections as the disease stabilizes.
- PRN (Pro Re Nata): injecting only when needed, based on OCT findings.
Regular OCT imaging of the retina is the basis for deciding the need for the next injection.
What to watch for after injection
Complications are rare, but contact the clinic immediately if you notice:
- Severe and increasing eye pain.
- Increasing redness over time.
- Sudden or noticeable loss of vision.
- Rising eye temperature or lid swelling.
A mild gritty sensation for a few hours and a small moving dark spot (the air bubble) lasting a few days are normal and expected.
Important note
The choice of medication and number of sessions is a medical decision based on accurate diagnosis, OCT imaging, and angiography when required. Treatment decisions cannot be made without an in-person examination.
Patient questions about intravitreal injections
Do injections improve vision or only stop decline?
It depends on the disease and timing. In eyes treated early, many patients notice improvement. In advanced cases, the primary goal is to prevent further decline.
Can I stop injections?
Some conditions (like RVO, once stable) need fewer injections over time. Others (like wet AMD) usually require long-term follow-up and ongoing therapy.
Do I need to fast or prepare in any special way?
No. You can have your usual meals and medications. Just avoid eye makeup on the day of the injection.
Can I drive after the injection?
It's best to have someone with you for the first session. After that, many patients can drive an hour or two later, though long drives on the same day are best avoided.
Clinical references
The material on this page is drawn from the following sources:
- American Academy of Ophthalmology (AAO) — Age-Related Macular Degeneration
- National Eye Institute (NEI/NIH) — Age-Related Macular Degeneration
- American Society of Retina Specialists (ASRS) — AMD Patient Information
- AAO — Diabetic Macular Edema (DME)
- ASRS — Retinal Vein Occlusion (RVO)
Educational content — the injection schedule is decided after OCT and fundus imaging.