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Eye injections are a treatment option for people with late-stage age-related macular degeneration (AMD). If you’ve never had an eye injection before, the thought of receiving medication this way may be intimidating. However, research shows that eye injections can slow vision loss for people with some types of AMD.
This article will help you learn more about how eye injections work and what you can expect during the procedure so you can feel less anxious.
AMD is the most common cause of vision loss in older adults. AMD usually occurs in older adults due to age-related damage to the macula, the part of the eye responsible for central vision and the ability to see colors and fine details. The macula is the center part of the retina — the light-sensitive membrane that lines the inside of the back of the eye.
People with AMD rarely lose their vision entirely. Instead, the condition can cause blurriness and blind spots in your central vision (what you see straight ahead of you). Central vision loss can make it difficult to take care of yourself and interfere with activities you enjoy, like reading.
The way AMD causes vision loss depends on the type of AMD you have.
There are two types of AMD — wet AMD and dry AMD.
Vision loss from the wet form of AMD can happen when new blood vessels form behind the macula. These abnormal, newly formed blood vessels are fragile and can leak blood and other fluids that can damage the macula. Vision loss from wet AMD can occur quickly — within days or weeks.
When the macula becomes damaged without the growth of abnormal blood vessels, it’s referred to as “dry AMD.” In dry AMD, macular damage occurs gradually as yellow deposits called drusen build up under the retina. Over time, drusen can cause an increasing number of cells in your macula to die, worsening your symptoms. Researchers also think that a part of the immune system called the complement system is overly active in people with AMD, which can damage the macula.
Most people with AMD have the dry form. AMD always begins dry and only becomes wet in about 10 percent of cases.
There are two types of eye injections that are approved by the U.S. Food and Drug Administration (FDA) to treat AMD — complement inhibitor injections and anti-vascular endothelial growth factor (anti-VEGF) injections.
Your AMD treatment depends on what type of AMD you have.
Complement inhibitor injections are the only treatment option available for people with geographic atrophy — the late stage of dry AMD.
Complement inhibitor medications work by blocking the complement pathway. Normally, the complement pathway helps your immune system fight harmful germs. In people with geographic atrophy, complement proteins trigger inflammation that damages the macula. By blocking the complement pathway, complement inhibitor medications can stop or slow damaging inflammation in your macula.
Examples of complement inhibitor medications include:
Anti-VEGF injections are a treatment option for people with wet AMD.
Anti-VEGF treatments work by blocking a protein called vascular endothelial growth factor. Too much VEGF protein can cause abnormal blood vessel growth and leakage. By blocking VEGF, these medications can prevent the formation of new abnormal blood vessels.
Examples of anti-VEGF medications include:
When you have AMD, you will continue to make the VEGF protein. This means you will likely need to continue to receive anti-VEGF injections to prevent further vision loss.
Read more about specific medications in this list of treatments for AMD.
Eye injections — also called intravitreal injections — for AMD are given at your eye doctor’s office. Most medications injected into the eye only last for a few weeks or months at a time. You will likely need an injection every four to six weeks, at first. The frequency of your injections depends on the type of medication you’re receiving and how your eye responds to the treatment. Your injections may become less frequent later on in your treatment.
The process of getting an eye injection usually only takes 10 to 15 minutes. However, your appointment may be longer than this to allow time for an eye exam and to speak with your eye doctor.
Before your injection, your eye doctor will numb your eye with an eye drop or gel, a medicated cotton swab, or a small injection to make you more comfortable during the injection. Next, your eye doctor will clean your eye to prevent infection. This is often done with a yellow iodine solution.
To help you keep your eyes open during the procedure, your eye doctor may use a device called a speculum. Instead of using a speculum, your eye doctor may also hold your eyes open. The injection usually goes in the white part of your eye in the lower, outer corner closest to your ear. Your eye doctor may ask you to look up to make sure the injection is in the right place.
The injection is made with a very thin needle. During the injection, you may feel:
As the medication mixes with the fluid in your eye, you may see a web of lines.
Immediately after the injection, your eye doctor will rinse your eye to remove the iodine. To make sure there aren’t any complications, your eye doctor may examine your eye with a light.
Most people can return to their normal activities immediately after receiving an eye injection. Your eye doctor may ask you to use antibiotic eye drops for a short time afterward.
Side effects from the eye injection usually only last a day or two after your injection and may include:
Talk to your eye doctor for more information about possible side effects. Your side effects may differ depending on which medication you are receiving.
Serious complications of eye injections are rare. Complications may include retinal detachment (when the retina is pulled away from its normal position) and endophthalmitis (an infection in your eye).
If retinal detachment occurs, you may experience:
If you have endophthalmitis, your symptoms may include:
Call your eye doctor right away if you notice any symptoms of retinal detachment or endophthalmitis.
If you have AMD, it’s important to talk to your ophthalmologist (eye specialist) about all of your treatment options.
You may consider asking your eye doctor the following questions:
On myAMDteam, the social network for people with age-related macular degeneration and their loved ones, members come together to ask questions, give advice, and share their stories with others who understand life with AMD.
Have you had eye injections to slow your vision loss from AMD? What was your experience like? Share your thoughts in the comments below, or post a comment on your Activities page.
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Christopher L. Haupert, M.D.
has 24 years of experience as a vitreoretinal surgeon with Iowa Retina Consultants.
Learn more about him here.
Amanda Jacot, PharmD
earned a Bachelor of Science in biology from the University of Texas at Austin in 2009 and a Doctor of Pharmacy from the University of Texas College of Pharmacy in 2014.
Learn more about her here.
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