Eye injections for macular degeneration

Macular degeneration is an eye condition that affects an area called the macula at the back of the eye.

It can occur at any age but is most common in people over fifty. This is known as age-related macular degeneration (AMD).

AMD affects your central vision and can cause blurred or distorted vision and make it difficult to perform activities such as reading, driving, or watching TV. It can affect one or both eyes.

There are two types of macular degeneration:

• Dry macular degeneration
• Wet macular degeneration

Dry (early) macular degeneration

This is the most common type of macular degeneration and affects around 90% of people with the condition. Dry macular degeneration develops slowly over many years and occurs when there is a build-up of waste material under the macular and a deterioration of the light-sensitive cells. There is currently no treatment for dry macular degeneration. The condition usually has mild symptoms and rarely causes blindness. A small percentage of people with dry macular degeneration go on to develop wet macular degeneration.

Wet (late) macular degeneration

Wet macular degeneration is the more serious form of the disease and can develop rapidly in a few weeks or months. It occurs when tiny abnormal blood vessels grow in the retina which then leak fluid and cause scarring. Wet macular degeneration needs to be diagnosed and treated quickly to prevent permanent scarring of the retina and loss of central vision.

Wet macular degeneration is caused by too much of a protein called vascular endothelial growth factor (VEGF) being produced in the eye. This substance causes an overgrowth of abnormal blood vessels in the macular leading to AMD.

Anti-VEGF medications are injected into the eye to counteract the effects of VEGF. The injections work by:

• Stopping the growth of new, abnormal blood vessels in the eye
• Reducing the leakage of blood and fluid from abnormal blood vessels
• Decreasing swelling of the retina

At your first consultation, you will be seen by a consultant ophthalmologist, a doctor specialising in conditions affecting the eye.

Your consultant will ask you about your symptoms, medical history, and general health. They will confirm your diagnosis with a dilated eye examination. This is where your consultant puts drops in your eye to dilate your pupils, allowing them to see inside your eye.

Why is this first consultation so important?

At Circle Health Group, your first appointment is important as it's where we get to know you and discuss your symptoms, diagnosis, and expectations for treatment. It's also an opportunity for you to ask your consultant any questions you may have about your diagnosis and treatment options.

At the end of your appointment, your consultant will decide whether eye injections are the right treatment for you based on your symptoms and diagnosis. They will explain what happens during the procedure as well as any possible risks and complications and what to expect during your recovery.

It is important to us that you are as well-informed and comfortable as possible before, during, and after your treatment, so please ask your consultant any questions you may have.

There's very little preparation needed before having eye injections for AMD.

Many people feel anxious about having an eye injection. Talking to your consultant about your concerns and asking them to explain what happens during the procedure can help put your mind at rest and ease any concerns you may have.

Tell your consultant about any medical conditions or allergies you have and any medication, including over-the-counter medicines you are taking.

You can eat and drink as normal before your eye injections.

At your appointment, you will be given eye drops to dilate your pupil in the eye that is to be injected. You will be asked to lie back on the examination couch.

Your eye will be numbed with local anaesthetic, which means you won't feel any pain during the procedure. Your consultant will clean your eye with an iodine solution. A small device will be used to keep your eye open and prevent you from blinking during the procedure.

Once the local anaesthetic has taken effect, your consultant will ask you to look in the opposite direction as they administer the injection into the white part of your eye. You will not be able to see what is happening or feel any pain, but you may feel mild discomfort or pressure. Some people see wavy lines as the medication mixes with the fluid in the eye. The medication is injected into the vitreous, the jelly-like substance inside the eye. The needle is very small and fine, and the injection takes less than a second.

When the injection is over, your consultant will hold a sterile cotton tip over the injection site for around ten seconds and apply light pressure to prevent fluid from leaking out. They will then wash your eye with a solution to lubricate it and prevent irritation.

You can normally go home after about an hour.

Your eye may feel sore and uncomfortable for a few days after your injection. It may also be watery and bloodshot. You can take over-the-counter painkillers such as paracetamol or ibuprofen if you need to. Applying a cool washcloth gently over your closed eyes can also help to soothe and relieve discomfort.

Your vision will be blurred until the dilating eye drops have worn off (normally around four to six hours). You must not drive during this time, and it may be more comfortable to wear sunglasses outside.

For at least twenty-four hours after your eye injection you should avoid heavy lifting, bending at the waist, and activities where substances could get into your eye like gardening, swimming, using eye makeup and rubbing your eyes.

How soon can I go back to work?

How soon you can go back to work after your eye injection depends on how you feel after the procedure and the type of job you do. Most people need to take a couple of days off work after having an eye injection.

How soon can I drive?

You should not drive until you can read a number plate from 20.5 metres away. Check with your consultant and inform your insurance company before driving after your eye injection.

When will I be back to normal?

How soon you are back to normal following your eye injection varies from person to person. Some people are back to normal within hours of the procedure, while others may feel soreness and discomfort for a couple of days. Most people are fully recovered and able to resume normal activities within forty-eight hours of having an eye injection.

While generally very safe, there is a small risk of complications associated with eye injections for macular degeneration.

Your consultant will explain all the possible risks and complications before your treatment.

Being as well-informed as possible about the risks and complications will help put your mind at rest and allow you to make an informed decision so please ask any questions you may have.

Possible complications of eye injections for macular degeneration include:

• Inflammation
• Bleeding in the eye
• Infection (endophthalmitis)
• Retinal tear or detachment
• Traumatic cataracts

Call the hospital immediately if you experience:

• Increased eye pain or discomfort
• Increased redness
• Increased pressure in the eye
• A sudden decrease or change in your vision
• A sudden increase in seeing floaters or flashing lights
• Increased sensitivity to light

We answer some of your most commonly asked questions about eye injections for macular degeneration.

How many eye injections do you need for macular degeneration?

How many eye injections you need for wet AMD varies from person to person and depends on the cause and severity of your condition. You may need to have injections from every few weeks to every few months.

Your eyes will be monitored each time you have an injection to see how well the treatment is working and when you will need another injection. Injections are normally spaced further apart as your condition improves. When there is a space of twelve weeks between injections and your AMD remains stable, your injections may be stopped.

What happens if you stop eye injections for macular degeneration?

When your AMD is considered stable and your vision is not getting worse, your ophthalmologist may decide you no longer need to continue having eye injections. After your treatment is stopped, you will need to have a yearly eye examination and monitor your eyesight yourself using a technique called the Amsler grid. This is a test you do yourself at home to monitor your vision and detect early signs of AMD.

In some cases, your injections may be stopped if your AMD is too advanced, or your condition is not improving.

Are eye injections for macular degeneration painful?

You will be given a local anaesthetic to numb your eye before your eye injection, so the injection itself will not be painful.

Once the anaesthetic wears off, you may have some mild discomfort in your eye for a few days. You can treat this yourself by taking over-the-counter painkillers and applying a cool washcloth over your eyelids several times a day.

How effective are eye injections for macular degeneration?

Eye injections are a highly effective treatment for wet AMD and prevent worsening of vision in around 95% of patients. Up to 40% of patients receiving eye injections to treat AMD also experience improved vision.

What drug is injected into the eye for macular degeneration?

The drugs injected into the eye to treat AMD are called anti-VEGF medications and work by counteracting the effects of a protein made by the body called vascular endothelial growth factor (VEGF). With AMD, too much of this protein is produced leading to symptoms of wet AMD.

Anti-VEGF medications include:

• Ranibizumab (Lucentis)
• Aflibercept (Eylea)
• Brolucizumab (Beovu)

Can I exercise after an eye injection for macular degeneration?

It's normally safe to exercise twenty-four hours after your eye injection. Check with your consultant when you can start exercising after your procedure.

How often do you need to have eye injections for macular degeneration?

How often you need to have injections for your AMD depends on your individual case. Injections may be given every one, two or three months for as long as you need them. Your consultant will perform an eye examination every time you have an injection to check your progress and decide when you need to have your next injection. As your condition improves, you will normally have injections less frequently until they can be stopped.

At Circle Health Group we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about eye injections for macular degeneration, book your appointment online today or call a member of our team directly on 0141 300 5009.

Content reviewed by Circle in-house team in March 2023. Next review due March 2026.

1. Treatments: Age-related macular degeneration (AMD), NHS
2. Age-related macular degeneration, NICE
3. Age-related macular degeneration, Moorfields Eye Hospital NHS Foundation Trust
4. Injections for macular degeneration: What to expect, Medical News Today