What are intraocular and periocular injections?

A variety of medicines can be injected directly into the eye for the treatment of numerous conditions of the retina and macula. Intraocular injections are administered directly into the vitreous cavity in the center of the eye through the white part of the eye, and periocular injections are administered behind the eye but outside the eye wall. Our doctors frequently give intraocular injections of molecular therapies, such as Lucentis® and Avastin®, as well as anti-inflammatory steroids for the treatment of macular edema in various conditions, including diabetic retinopathy, retinal vascular occlusions, and wet macular degeneration. These medicines act at the molecular level to decrease leakage of fluid from abnormal blood vessels within or under the retina. Injection therapy is the most advanced treatment and the current standard of care for most forms of wet macular degeneration. For this type of treatment, fluorescein angiography, ICG angiography, and/or OCT may need to be performed before the procedure so that the doctor can measure the amount of fluid leakage.

What to expect

Before your procedure, the doctor will perform a dilated retina examination. Then, you will be seated comfortably in the procedure room and anesthetic eye drops will be placed in your eye. Once the surface of the eye is numb, a cotton swab soaked in a thicker anesthetic jelly will be placed on the surface of the eye to numb the deeper layers of the eye wall. It will take about 30 minutes for the numbing medicine to fully work, keeping your eye comfortable during the procedure. Your comfort is an important priority for our doctors and staff, and we will make every effort to ensure a pleasant experience. Typically, after the numbing takes effect, most patients report not feeling anything during the actual injection.

After the eye is anesthetized, an antiseptic solution is applied to the surface of the eye, the eyelashes, and the eyelids to sterilize the area. A small retractor is placed between the eyelids to help you avoid blinking during the procedure, and then a small amount of medicine is injected into the eye. Your eye will then be rinsed and an antibiotic eye drop will be administered. The entire procedure takes about 45 minutes to an hour, mainly because we allow ample time for dilation and numbing of the eye. You will not need to wear an eye patch after your procedure.

Your doctor will discuss all of the above with you and review additional information and precautions before and after your treatment. Our goal is to have all of your questions answered, so please feel free to ask our doctors and staff about any questions or concerns you may have.