Stability and Stress: The Emotions of an Eye Injection Appointment

There are days and then there are days. Those of us with wet macular degeneration (AMD) approach the day of our injection with very mixed emotions. I, personally, am both anxious and content, and feel stable and stressed.

Moving toward contentment

I'm content that I have prepared the best I can. That includes clearing my calendar for the day to deal with the reality of the dilation that makes seeing more difficult. I take 2 acetaminophen several hours beforehand at my retina specialist’s (RS's) suggestion to deal with any post-injection pain and have an ice pack ready to soothe me and my eye.

Minimizing stress

All that means I’m minimizing the stress. Soothing music on the ride over and back. Deep breathing to calm, before and after.

At the office, I work on being cheerful and understanding of the staff and their challenges. If any of my fellow patients seem willing to talk, I’ll chat. Makes the time go faster and takes me out of my own worry.

I’ve worked at this because (confession time) I have in the past been withdrawn and cranky. That doesn’t help, I have learned.

The reality is that those of us with AMD are often dealing with other stressful situations. That is particularly true in this economy. Especially if we are of a certain age, with other health concerns.

The anxiety of vision test

My anxiety on injection day almost always involves the results of the vision tests.

The eye chart. How much of it can I read? The AMD in my left eye is pretty advanced so I have to work at seeing the big letter 'E'. I’m working on using my peripheral vision to see that one. The right eye is much better but still not great. I don’t know about you but I hate failing tests, even one for which I cannot study.

The pressure test

After drops to numb the surface of the eye, they use a tiny instrument to touch the surface of my eye and flatten the cornea, which measures the pressure. I work on being relaxed and still. Changes in pressure can signal the development of glaucoma. And yes, we can have both AMD and Glaucoma. Then they dilate the eyes.

The Amsler Grid

Are the lines straight or wavy? Which ones? Can you see the dot in the middle? Some RS offices check it; others don’t.

Optical coherence tomography

Next up... Optical coherence tomography (OCT). It is this machine along with the anti-VEGF injections that transformed the diagnosis and treatment of wet-AMD. It allows that doctor to see what has happened to your retina.

I learned from MacularDegeneration.net’s article that the OCT is similar to ultrasound, but instead of using sound waves, it uses light to obtain images of tissues. After your eyes are dilated, a special machine will shine a light beam at your eyes to visualize the retina and underlying ocular structures.

Here’s where my anxiety kicks in. What does the OCT show? Changes in the retina? More damage? Or stability?

Taken to the room, I sometimes pace. The doctor comes in and looks at the OCT pictures and into my eyes. I can’t resist:

“What are you seeing?”

“It is stable. No changes.”

Preparing for the shot

I inwardly shout “Hallelujah” and get ready for the injection. More numbing, a few drops of betadine to prevent infection, the injection, and home I go.

By the way, this past month my eye reacted to the betadine but lots of flushing with sterile water and eye drops at home and it was over by the next morning.

My new motto

The more I’ve learned about AMD and its treatment, the more prepared and content I can be on the day of the injection. I know that it is possible that my eye will someday not be stable but until then, my motto is “More Content, Less Anxious.”