Injectable medications, such as anti-VEGF and steroid medications, are vital in protecting vision with macular edema.
As with any injection, there is a small risk of complications. However, the benefits of the medication may outweigh the risk of side effects. Talk with your doctor about macular edema injections, possible side effects, and the best option for you.
This article discusses injections as part of macular edema treatment, including their procedure, recovery process, effects, and possible risks.
What is the procedure like and what can I expect?
Doctors will inject medications for macular edema through the white of the eye, into the eye’s inner vitreous fluid. This is known as an intravitreal injection.
The procedure for macular edema treatment injections is as follows:
- A clinician will use eye drops, gel, or small injections to put anesthetics in the eye.
- The doctor will remove any pathogens in the eye and use a povidone-iodine solution to prevent infection.
- Clinicians may place an eyelid speculum — a noninvasive tool that helps keep the eyes open.
- Your doctor will then inject the medication through the white of the eye with a thin needle.
- Finally, clinicians will remove the speculum and clean the eye again.
The entire procedure will take about 10–15 minutes.
Eye doctors often perform macular edema injections in an outpatient clinic or office.
What medications are injected?
Doctors may use the following injectable medications to treat macular edema.
Anti-VEGF medications can help reduce swelling, lower the risk of vision damage, and sometimes improve vision.
The medications do this by blocking the activity of immune proteins that damage the eye. As a result, they can reduce fluid and blood leakage from fragile blood vessels.
Anti-VEGF medications include:
- aflibercept (Eylea)
- bevacizumab (Avastin)
- brolucizumab (Beovu)
- faricimab (Vabysmo)
- ranibizumab (Lucentis)
Read more about macular edema and how it affects the eye.
Steroids can help reduce swelling and inflammation in the eye.
Common steroid medications for macular edema include:
- triamcinolone acetonide (Kenalog, Triescence)
- dexamethasone (Decadron, Dexone, TaperDex)
- fluocinolone acetonide (Iluvien, Retisert, Yutiq)
However, steroids may increase the risk of cataracts and glaucoma. Regular eye checkups are essential if you receive steroid medications for any eye condition.
How often do I need macular edema injections?
How often you will need injections to treat macular edema can depend on factors such as:
- the medication used
- your condition’s severity
- how your condition responds to initial injections
Doctors often administer anti-VEGF injections once a month, according to the National Institutes of Health (NIH).
With time, you may need injections less frequently. Some people may eventually be able to stop treatment. However, other people may need to have anti-VEGF medications regularly for several years.
Talk with your medical team for advice about your treatment plan and injection schedule.
How do I recover after eye injections?
You may be able to return to your usual daily activities immediately after the injection. However, recovery and treatment plans vary. Doctors may recommend a checkup appointment 4–6 weeks after your injection. If you experience mild irritation after your injection, doctors may recommend eyedrops or artificial tears.
Your medical team will advise about your specific recovery.
What are the risks of intravitreal injections?
Some people experience mild side effects for 1–2 days after the injection, such as:
- a feeling of irritation
- seeing floating bubbles in your vision, similar to floaters
- mild pain or irritation
- a feeling of something in your eye
Contact an eye doctor as soon as possible for any new, severe, or persistent side effects, such as persistent pain or worsening vision.
Intravitreal injections carry a risk of complications, either due to the injection or the medication used. However, the American Society of Retina Specialists notes that severe complications are rare.
Possible complications from macular edema injections include:
- infection
- high pressure in the eye
- eye inflammation
- bleeding in the eye
- retinal detachment
- increased risk of cataracts and glaucoma
Other frequently asked questions
Katherine E. Duncan, MD has also reviewed the answers to the following frequently asked questions.
Will injections for macular edema hurt?
A healthcare professional will provide a local anesthetic, so injections for macular edema shouldn’t hurt.
However, you may feel pressure or an aching sensation during the procedure. You may also experience mild, temporary eye pain or discomfort during recovery.
Tell your doctor if you experience pain or severe discomfort during or after the procedure.
How do I keep my eye open and still during an injection?
Doctors will use an eyelid speculum to keep the eye open.
They will also ask you to look in a specific direction to keep the eye still and show more of the eye’s white so they can administer the injection.
How many injections do I need in a visit?
Generally, you will need only one injection per eye being treated.
Sometimes, doctors administer local anesthetics via injection. They may apply numbing drops first or give the injection in the surrounding area rather than directly into the eye.
Injected medications are a common treatment for macular edema to help reduce swelling and eye damage, protecting vision.
Doctors inject the medications through the white of the eye into the vitreous fluid, known as an intravitreal injection. You will be given an anesthetic to reduce pain.
Some people experience mild, temporary side effects of discomfort. Intravitral injections also carry a small risk of complications. Contact an eye doctor as soon as possible if you notice any new, persistent, or concerning symptoms after treatment.