What to Expect With Eye Injections for AMD

As we age, our eyesight can face challenges. One of the most common is age-related macular degeneration (AMD). AMD is an eye condition that affects the central part of the retina, called the macula. The macula is responsible for sharp, central vision. There are 2 types of AMD: dry AMD and wet AMD.¹

What is the difference between dry AMD and wet AMD?

Dry AMD is the more common form of the disease. Dry AMD occurs when the macula thins and breaks down over time. This leads to blurry vision and difficulty seeing in low light. It may progress to blind spots in your central vision.¹

Wet AMD is less common but more serious. Wet AMD always starts with dry AMD, but dry AMD does not necessarily turn into wet AMD. With wet AMD, abnormal blood vessels grow in the back of the eye, damaging the macula.¹

When these blood vessels leak fluid or blood, it causes rapid damage to central vision. This can result in a reduction or total loss of vision, making it hard to do daily tasks like reading or driving.^1,2

People with myopic macular degeneration (MMD) can also develop abnormal blood vessels under the retina. But the disease process in MMD is not age-related as in wet AMD.³

While treatment cannot reverse the damage of wet AMD or MMD, treatment methods in the form of eye injections (shots) are available to help slow or even stop the progression.^1,2

What are eye injections?

In recent years, eye injections – also called intravitreal injections – have become a vital part of wet AMD treatment. Eye injections deliver medicine directly into the eye, targeting the underlying cause of the disease. The most common medicine used in these injections is called anti-VEGF (vascular endothelial growth factor) therapy.^1,2

What is anti-VEGF treatment, and how does it work?

A protein called vascular endothelial growth factor (VEGF) is what signals the growth of abnormal blood vessels in the retina. Anti-VEGF drugs work by blocking the growth of these abnormal blood vessels. This reduces leakage and prevents further damage to a person’s central vision. By targeting the underlying cause of wet AMD, these injections can help stabilize vision and prevent the disease from getting worse.²

There are several kinds of anti-VEGF medicines. The dosage and injection schedule will vary depending on how severe your disease is and how you respond to treatment. Examples of anti-VEGF drugs are:^4,5

• Aflibercept (Eylea^®)
• Bevacizumab (Avastin^®)
• Brolucizumab (Beovu^®)
• Faricimab (Vabysmo^®)
• Ranibizumab (Lucentis^®)

What to expect from eye injections

Getting an eye injection might sound scary or intimidating. But the process is relatively simple and quick. The injection itself is typically performed by a retina specialist in a doctor’s office or outpatient clinic.^2,4

The procedure involves the following steps:^2,4,5

1. First, your eye doctor will clean your eye and eyelid with a yellow iodine solution. They will then numb your eye to minimize discomfort. They may use numbing drops, a gel, or even a numbing shot.
2. After your eyes are numbed, they will use an eyelid holder to keep your eyelids open during the injection.
3. The place of injection will be measured. The injection usually goes in the outer lower part of the eye, near your ear.
4. You will be asked to look up, and the injection will take place.
5. Once the injection is done, your doctor will look at your eye and clean around it with an eyewash solution.

The entire injection process usually takes just a few minutes once the eye is numbed. You might feel some pressure or nothing at all. But you should not feel significant pain. You also might see some wavy lines or floaters as the medicine is distributed around the eye.^4,5

How to care for your eye(s) after eye injections

After you receive an eye injection for your wet AMD or MMD, your doctor will provide instructions on how to care for your eyes and any precautions to take following the procedure. Instructions may include:^4,5

• Using prescribed eye drops
• Avoid rubbing your eyes
• Coming back for follow-up appointments to see how you are doing
• Do not wear contact lenses for 2 days after
• Avoid swimming or getting water into your eyes for several days

Over the next day or so, it is common to experience some mild discomfort or soreness in the eye, along with foggy vision or floaters. These side effects should go away on their own.^4,5

If you do have soreness, this is easily taken care of with over-the-counter pain medicine like Tylenol^® or Advil^®. You can also relieve soreness by gently holding a clean, cool washcloth to your closed eye for 10 minutes at a time. If either of these methods does not help, call your doctor.⁴

Complications to be aware of

Eye injections are generally safe, and most people can get them without major problems. But, like any medical procedure, they carry some risks. Sometimes, during the injection, the needle may hit a surface blood vessel and break it, causing the white of the eye to look red and bloody. This can last several weeks, but it is generally painless, should not affect your vision, and should go away on its own.⁴

Serious complications of eye injections are very rare. But if they occur, they can threaten your vision. Get immediate medical attention if any of the following occur:⁴

• Eye infection (endophthalmitis) – symptoms include blurry vision and pain that does not go away
• Retinal detachment – symptoms include an arc of flashing light in your peripheral (away from the center) vision, floating spots or lines that move with your eye movement, or part of your vision becoming totally blocked (almost like a “curtain” is drawn on part of your eye)

Call your doctor if you experience anything out of the ordinary or pain that does not go away.⁴

Establishing a treatment plan

Once you have been diagnosed with wet AMD or MMD, your eye doctor will talk with you about which treatment is best for you, as well as what dosing schedule you will be started on. Once they evaluate how your eye responds to treatment, the medicine and dosing interval may change.⁴

Many people find that their vision becomes more stable after receiving eye injections. Some may even experience improved vision. If you have any questions about eye injections, talk with your doctor.⁴