Most patients experience little or no pain with intravitreal injections. Our practice has published a study showing that, with optimal anesthesia, very few patients experience significant pain. For a pdf of the study click here
. There are two main ways of numbing the eye for injections. Topical only anesthesia involves using anesthesia drops, gel, and/or cotton soaked swabs. Subconjunctival anesthesia involves using topical anesthesia followed by an injection of subconjunctival lidocaine. There are advantages to each type of anesthesia. Topical only is faster and generally causes less irritation to the eye after treatment. It also carries a decreased risk of subconjunctival hemorrhage. Unfortunately, more people feel significant pain with topical only anesthesia (but not all people). Subconjuntival anesthesia usually affords people better pain control. Main patients treated with intravitreal injecitons following subconjunctival anesthesia don't even realize they've been given an injection because there is no pain. Unfortunately about 5 percent of patients have difficulty with post-injection reactive pain when treated with subconjuctival lidocaine. Also, there is a higher risk of subconjuntival hemorrhage (bleeding on the surface of the ey) with subconjunctival lidocaine. In our study, 90 percent of patients preferred subconjunctival lidocaine and 10 percent preferred topical anesthesia only.