Injections for macular degeneration: What to expect

Macular degeneration is a condition that causes damage to the macula, which is part of the retina. Macular degeneration accounts for roughly 8.7% of cases of blindness worldwide.

There are two types of macular degeneration: wet and dry. The dry form can convert into the wet subtype.

A 2021 review explains that wet macular degeneration occurs when there is the presence of a protein called vascular endothelial growth factor (VEGF). VEGF promotes the production of blood vessels. In people with wet macular degeneration, an excess of VEGF causes the formation of too many blood vessels around the retina.

This process primarily affects the macular, causing vision problems. These include the following symptoms:

• blurred vision
• visual distortions
• blind spots

When to consult a doctor

Without treatment, wet macular degeneration is likely to cause serious vision loss. For this reason, anyone experiencing symptoms of wet macular degeneration should seek advice from a doctor.

Earlier treatments enable doctors to slow the progression of the disease as much as possible.

For some people, the thought of having intravitreal injections may cause concerns. However, a person can ask medical professionals questions about these injections to help alleviate these concerns.

Doctors will also inform people about the potential complications of the procedure. These include:

• discomfort and pain as the anesthetic wears off
• subconjunctival hemorrhage, which refers to eye bleeding
• in rare cases, other complications, such as:
  • traumatic cataract
  • retinal tears
  • endophthalmitis, a bacterial or fungal infection that affects the eye tissue

Doctors can treat wet macular degeneration with intravitreal injections. These are injections that doctors insert into the vitreous, the area near the retina at the back of the eye.

As a recent paper from 2022 explains, this treatment works using a needle to inject certain medications into the person’s eye. The function of these medications is to reduce the potency of VEGF, which helps prevent the disease from worsening.

There is solid evidence that these intravitreal injections can prevent some vision loss in people with wet macular degeneration. Among people with wet macular degeneration, 20–30% of those receiving these injections will lose at least six lines of vision, in comparison with 50–60% of those who do not receive this treatment.

A 2020 paper explains that intravitreal injections can occur in the operating room or a doctor’s office.

After administering the anesthesia and cleansing the eye, the medical team will ask the person to look in the direction opposite to where they intend to insert the syringe. After a brief warning, the doctor or surgeon will insert the syringe into the person’s eye before injecting the VEGF inhibitors therein. The injections will only take a few moments.

The study also notes that the medical team may irrigate and lubricate the eye after the injection.

Effectiveness

It is important to note that this treatment is only effective with regular injections. The 2020 research suggests that intravitreal injections of VEGF inhibitors are most effective when doctors administer them every 4–6 weeks.

Research suggests that healthcare professionals can help make the procedure go as smoothly as possible by following certain steps. These include:

• playing relaxing music
• providing a comfortable neck pillow
• allowing people to hold someone’s hands if possible
• providing a verbal warning just before the injection takes place

Follow-up

Doctors may recommend avoiding certain activities at least 24 hours after receiving this treatment. This is to avoid any bacteria or other organisms near the injection area. These include:

• gardening or yard work, as plant matter could get into the eye
• swimming
• wearing eye makeup
• rubbing the eyes

As noted above, the outlook for people with wet macular degeneration varies greatly on whether or not they receive timely treatment. Intravitreal injections can greatly reduce symptoms and lower the risk of a person losing their vision.

However, even with treatment, wet macular degeneration can be a challenging condition to live with and, in some cases, may cause emotional distress. A person should seek support and mental health care, which may help address any complications or concerns surrounding the diagnosis and treatment of macular degeneration.

Macular degeneration is a condition that accounts for many cases of blindness. Wet macular degeneration involves new blood vessels forming around the retina, causing vision loss.

Intravitreal injections can greatly improve the symptoms of wet macular degeneration.