Jordan Eye Center
Dr Muataz Mohammad Harara practises ophthalmology with a focus on retinal and vitreous disease. His work includes retinal treatment and injections, cataract and…
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An intravitreal injection delivers medication through a very fine needle into the cavity of the eye so that it acts directly on the retina and the macula. The reason for this route is simple: drops and tablets do not reach the back of the eye in effective concentration, whereas an injection places the drug exactly where the problem is. It is performed in a sterile room or an operating theatre under local anaesthetic drops, takes only minutes, and you go home the same day. The commonest indications are diabetic macular oedema, wet age-related macular degeneration, retinal vein occlusion, growth of fragile new blood vessels inside the eye, and certain inflammatory conditions. The medicines used fall into groups that either suppress vessel growth factors or control inflammation, and your doctor selects between them according to the diagnosis and your response. It is not appropriate to request a drug by name because it worked for someone else. One fact must be clear from the very first session: **this is continuing treatment, not a single dose**. Injections are given on a repeating schedule determined by how your eye responds, monitored with retinal cross-sectional imaging and, where needed, angiography. Sessions are often close together at first and are then spaced out if the condition stabilises. Dropping out of the schedule or postponing sessions without a medical reason gives back the improvement that was gained, and return of fluid or bleeding after stopping is an expected outcome in many cases rather than an exception. The limits are explicit. Injections stabilise vision or partly improve it in many eyes, but they **cannot restore sight lost to scarring or atrophy at the centre of vision**, cannot repair retina whose tissue has died, do not correct refractive error, and are not a treatment for every kind of poor vision. They also **do not in any way replace control of blood sugar, blood pressure and cholesterol**: the eye is treated twice over, inside with injections and outside by controlling the disease that damaged it. Suitability and the injection schedule are decided by examination and imaging, not by reading.
1 specialists
Procedure steps
- 1
Assessment and imaging before the decision
Vision and eye pressure are measured, the back of the eye is examined after dilation, and cross-sectional retinal imaging is performed to show macular thickness and fluid, with angiography added where needed. These images are the baseline against which every later visit is compared, which is why they are repeated at intervals to decide whether another injection is due or the interval can be extended.
- 2
Preparation and sterile technique
Anaesthetic drops are instilled, the skin around the eye is cleaned and the ocular surface is disinfected with a sterile solution, then a sterile drape and a lid speculum are applied to keep the lashes away from the injection site. This step is not a formality: correct sterile technique is what reduces the risk of the most serious complication of the procedure, infection inside the eye.
- 3
The injection itself
You are asked to look in a specific direction and hold your gaze steady, then a very fine needle is passed through the white of the eye at a carefully chosen site away from the lens and retina, and the medicine is delivered within seconds. You usually feel pressure or a brief sting rather than sharp pain, and you may afterwards see a shadow or small bubbles drifting across your vision, which is expected.
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Post-injection check
The team confirms that you can see hand movement or light, eye pressure is measured when needed since it can rise temporarily after injection, and the drops and warning signs are explained before you leave. In most cases no patch is applied, you are told not to rub the eye, and you are advised not to drive yourself home after the session.
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The schedule and long-term follow-up
A schedule is set according to your diagnosis and response, and cross-sectional imaging is repeated periodically to decide whether to continue, extend the interval or change the medicine. The expected duration is explained frankly, because in many conditions it is measured in months and years, and control of blood sugar and blood pressure is emphasised, since it changes the course of the disease more than any single injection.
Before the procedure
Bring someone to take you home, since driving after dilation and injection is not advised, and bring sunglasses. Tell your doctor if you have any inflammation, redness or discharge in the eye or eyelid, or an active sinus or dental infection, because active infection may postpone the session until it is treated. Report any allergy, particularly to iodine or antiseptic solutions, and give a full list of your medicines including blood thinners, but do not stop any of them on your own. Bring your latest blood glucose reading, your glycated haemoglobin result and your latest blood pressure reading, since these are part of treating your eye rather than side information. Eat and take your usual medicines unless told otherwise, bring previous reports and scans, and keep to your appointment, because postponing sessions loses the gains your eye has made.
After the procedure
Use the prescribed drops exactly as directed, do not rub or press on the eye, and avoid swimming, dust and eye make-up in the first days. Expect a gritty sensation, mild redness at the injection site, and floaters or small bubbles drifting in your vision, all of which settle within a day or a few days. **Seek same-day review for increasing eye pain, spreading severe redness, a clear drop in vision, marked light sensitivity, or purulent discharge, as these may indicate infection inside the eye, an emergency that must be treated as quickly as possible and never left until your scheduled visit.** **Also seek review for a black curtain, sudden flashes of light or a large increase in floaters, since these may mean a retinal tear.** Do not be late for your next scheduled injection.
Expected duration
The injection itself takes seconds, while the whole visit including preparation, sterile technique and the post-injection check usually takes 20 to 45 minutes, and longer if imaging is done too. You go home the same day and the gritty feeling lasts hours. The schedule follows your response, often monthly at first then extended, and treatment usually continues for months to years.
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