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Has your doctor suggested eye injections to treat your diabetic retinopathy? Are you apprehensive because you don’t know what to expect? You’ll be happy to learn that not only are these treatments often effective at halting the progression of diabetic retinopathy, but most people report little to no pain during the procedure.
Here we’ll provide you with some important information about how eye injections can help preserve your sight.
Being familiar with how diabetic retinopathy develops is helpful when it comes to understanding its treatment. Blood vessel damage is a common complication of diabetes. Diabetic retinopathy occurs when the blood vessels that supply your retina, the delicate tissue layer in the back of your eye that senses light, are damaged.
The damaged vessels can leak blood and fluid into the retina. The blood and fluid can build up and cause swelling in the center of the retina, called the macula. This is known as macular edema. As diabetic retinopathy advances, these diseased blood vessels close and the retina is deprived of oxygen. In an attempt to keep a good blood supply to your retina, abnormal new blood vessels may grow. But the new blood vessels tend to be fragile, resulting in more bleeding and membrane formation. This can lead to symptoms such as blurry vision, dark spots or blank spots in your visual field, difficulty seeing colors, and even permanent vision loss over time.
Special eye injections are used to treat advanced cases of diabetic retinopathy. There are two main types available:
- Anti-vascular endothelial growth factor (VEGF) injections: These injections block VEGF, a protein in the body that stimulates the growth of abnormal new blood vessels in the eye. This reduces the amount of fluid and swelling in the retina. Anti-VEGF injections include ranibizumab (Lucentis), aflibercept (Eylea), and bevacizumab (Avastin). They are usually given monthly in the beginning, but treatments may be spread out over longer intervals as time goes on.
- Corticosteroid injections/implants: Steroids are used to decrease inflammation in the eye, which improves macular edema. Triamcinolone (Kenalog) is an injection that stays effective for 4 to 6 weeks. Implants containing corticosteroids can also be injected and last much longer. Dexamethasone (Ozurdex) implants work for 3 to 4 months, while fluocinolone acetonide (Iluvien) remains active for up to three years.
Your doctor will determine which eye injection or combination of treatments is best for you. Since diabetic retinopathy is progressive, the goal is to diagnose and treat it early, before any permanent changes in your vision take place.
Injections to treat diabetic retinopathy are given into the vitreous of your eye, the gel-like substance between the lens and the retina of your eye. Prior to the injection, your doctor may do a quick eye exam to re-confirm earlier findings and will numb your eyes with anesthetic drops or gel. Your eyes are then cleaned using an antiseptic solution to remove bacteria and prevent infection.
An instrument called a speculum will be used to gently hold your eyelids open. A tiny needle is used to deliver the medication. You may feel pressure or a slight sting during the actual injection. Once the injection is complete, the speculum will be removed, and your eye will be cleaned. Your eye will then be re-examined for any complications.
Shortly afterwards, your eye may feel irritated or have a gritty sensation. You may be given eye drops to help with this. Occasionally, a small red spot can appear on your eye where the injection was given. This is caused by a small blood vessel in your eye called a capillary and will clear up in about a week. You may also notice moving black spots in your vision called floaters, but they should disappear in the first day or so.
Most people tolerate the injections without any serious side effects, but be sure to contact your doctor if you notice:
- severe pain
- signs of infection, like pus draining from your eye or extreme redness
- decreased vision
- increased floaters
It’s believed about one-third of diabetic adults over age 40 have diabetic retinopathy, and there are often no symptoms in the early stages. So, in addition to maintaining good blood sugar levels, your diabetes treatment plan should include yearly dilated eye exams to check for any changes.
