Department of Ophthalmology University Hospital Ayr Intravitreal injection Information for you Follow us on Twitter @NHSaaa Find us on Facebook at www.facebook.com/nhsaaa Visit our website: www.nhsaaa.net All our publications are available in other formats
For some drugs to be effective, it is necessary to inject the drug directly into the eye itself. This is called an intravitreal injection, which is carried out in a clean room or theatre by a specially trained nurse or doctor. The procedure itself normally takes 15 minutes, with the injection taking about 20 seconds. However, you should expect to be in the department for up to two hours - this allows for preparation before your procedure. To get the injection, you will lie down on a couch. Local anaesthetic drops are placed in your eye to numb the surface. Staff will clean your eyelids and the surface of your eye with an antiseptic solution to prevent infection, and then cover your face with a small sterile drape. A small clip called a speculum is used to keep your eyelids open during the procedure. More local anaesthetic eye drops are placed into your eye. The injection site is marked with a small calliper (measuring device). After this, you will receive the intravitreal injection. Your vision will be assessed after the injection, by checking you can see hand movements or count fingers. 2
Antibiotic eye drops are also placed in your eye to prevent infection. Before the injection Carry out eyelid hygiene for one week before your injection. You can use either sodium bicarbonate (baking soda) or baby shampoo. You should prepare a fresh solution each day. Sodium bicarbonate solution Add a quarter of a teaspoon of sodium bicarbonate to a cup of cooled boiled water and mix thoroughly. Diluted baby shampoo Dip the tip of a clean cotton bud into baby shampoo and mix this into half a cup of cooled boiled water. Always wash your hands first. Use cotton buds dipped in cooled boiled water. Use each cotton bud once, on one eye only and then throw away. You may need several cotton buds for each eyelid. Never place a used cotton bud back into the cleaning solution. 3
Do not clean inside the eyelids. Thoroughly cleanse the edge of the eyelids and remove any crusts, paying particular attention around the roots of the eyelashes. Do not use contact lenses on the day of, or the day before your injection. Do not use any cosmetics on the day of your injection. After the injection You may receive eye drops to take home. Please use these as instructed. Occasionally, we may ask you to wait to have your eye pressure checked before you go home. You should avoid getting soapy water in your eye or swimming for a few days after your injection. You may resume wearing contact lenses three days after your injection. 4
Common side effects following an intravitreal injection: Your eye may feel gritty and ache slightly for a day or two after the injection. Your vision may be slightly blurred for one to two days after the injection. You may see floaters or spots. This will resolve in a few days. You may also experience a brief episode of flashing or swirls of light immediately following the injection. There may be some discomfort and redness of your eye for the first few days after the injection. This is often due to the antiseptic solution. Your eye may become red. This is usually due to a small bleed on the outer white part of the eye (subconjunctival area), at the injection site. This shouldn t be painful and should clear up within one to two weeks. 5
Serious side effects: Serious eye infection (one in 3,000 cases) which can lead to blindness. If you experience any severe pain, decreased vision or prolonged blurred vision, sensitivity to light, redness which is much worse than after your injection or discharge from your eye, contact the Eye department immediately. Delays in seeking advice may be detrimental to your vision (see contact numbers on page 7). Less common side effects: cataract; retinal detachment; raised pressure in the eye, or blood clots and bleeding in the eye. If you are concerned or experience any sudden deterioration in vision or pain, contact the Eye department. 6
What happens next? Most patients receiving intravitreal injections require a course of treatment, the doctor at the eye clinic will discuss this with you. Following the initial course, you will have a review at the eye clinic. For many patients, further intravitreal injections are required to maintain the benefits of treatment. If you have any concerns about your eye after your injection contact: Eye department contact details Monday to Friday 9am to 5pm telephone 01292 610555 ask for extension 14464. If you feel your eye problem is urgent outwith these hours, please telephone 01292 610555 and ask for the on-call eye doctor. Appointment enquiries Claire Greer, Macular Co-ordinator: Monday to Friday 8 am till 4 pm telephone 01292 610555 ask for extension 14030. 7
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