Intravitreal Injections 101: What Sarasota Residents Need to Know About Eye Treatments

Sarasota residents, many of whom enjoy the beaches and cultural attractions like the Ringling Museum, facing severe retinal conditions now have a clearer understanding of a common and effective treatment: intravitreal injections. Over the last decade, these in-office procedures have become a mainstay for addressing various eye ailments, directly delivering medication to the vitreous, the gel-like fluid filling the eye.

This method allows for a high concentration of medication to reach the retina, treating conditions that can lead to significant vision loss. These include age-related macular degeneration, diabetic retinopathy, and retina vein occlusions. Beyond these, intravitreal steroids are utilized for patients experiencing retinal swelling due to conditions like cystoid macular edema, diabetic macular edema, uveitis, or other inflammatory issues. Eye infections such as retinitis and endophthalmitis can also be treated with injected antibiotic, antiviral, and antifungal medications.

Types of Injections Explained

Three primary types of drugs are commonly injected:

• Anti-VEGF Drugs: These medications, including Eylea, Avastin, Lucentis, and Vabysmo, target vascular endothelial growth factor (VEGF), a protein that promotes the growth of abnormal blood vessels. Such vessels can disrupt vision in conditions like age-related macular degeneration or diabetic retinopathy. Injections inhibit this growth, preserving or improving vision. Initially, monthly injections may be required, but frequency often decreases over time, with some patients eventually discontinuing treatment.
• Steroids: For active inflammation not controlled by topical treatments, intravitreal steroid injections can be beneficial. Conditions such as cystoid macular edema, scleritis, and uveitis may be treated with common steroid medications like Ozurdex, Triescence, and Kenalog.
• Antibiotics, Antivirals, and Antifungals: To combat eye infections like endophthalmitis and retinitis, direct injection of medications such as ceftazidime and vancomycin offers the most effective access to the infection site, preventing detrimental effects on vision.

The Procedure: What to Expect

The procedure is performed in-office by a retina specialist. Patients are reclined, and a numbing drop or gel is applied to minimize discomfort. Betadine is then used at the injection site and sometimes along the lash line to prevent bacterial entry. An eyelid speculum keeps the eye open during the brief process. The medication is administered with a small needle into the pars plana, the white part of the eye, with the entire process typically lasting 10-15 minutes. Patients might feel a slight pinch and pressure.

After the Injection

Restrictions post-injection are minimal, though patients should avoid exposing the eye to potential contaminants on the day of the procedure. Minor side effects can include small floaters or a bubble in the eye from microscopic air within the medication. Discomfort from the betadine drops is also possible but usually subsides within 24 hours with artificial tears.

Understanding the Risks

While severe complications are uncommon, potential risks include eye infections (endophthalmitis), vitreous hemorrhage (bleeding in the eye's gel-like fluid), inflammation (uveitis), and retinal detachments. Endophthalmitis is the most serious, requiring immediate treatment if worsening vision or severe pain occurs 1-7 days after the injection. Fortunately, due to stringent preventative measures, the risk of infection is less than one in 5,000.

Sarasota residents with concerns about their vision, whether in Downtown Sarasota or coastal neighborhoods like Siesta Key, are encouraged to consult with a retina specialist to discuss if intravitreal injections are a suitable treatment option.