Eye Injections (Intravitreal Therapy) — What to Expect

If you have been told you need eye injections, the most important thing to know is that the procedure is almost always much easier than patients expect.

Intravitreal injection therapy is the main treatment for macular degeneration, retinal vein occlusion, and diabetic macular oedema. The medication is delivered directly into the eye to reduce fluid, control abnormal blood vessel activity, and stabilise or improve vision.

Injections are performed on-site in Miranda, with each treatment guided by the same specialist who manages your ongoing care.

Why Do You Need Eye Injections?

Many retinal conditions are driven by leakage from abnormal or damaged blood vessels in the macula — the central part of the retina responsible for sharp, detailed vision. This leakage causes fluid to build up, disrupting the structure of the retina and reducing vision.

Anti-VEGF medications work by blocking the biological signals that drive this abnormal vessel growth and leakage. Delivered directly into the eye, they reach the retina in concentrations that would not be possible through a tablet or intravenous route. The result, in many patients, is a meaningful reduction in fluid and — in conditions like retinal vein occlusion — genuine recovery of vision that was previously lost.

The thing that still gets me is watching a patient whose vision has been falling away — and then seeing that process stop, and in many cases begin to reverse.

— Dr Adrian Hunt, FRANZCO PhD

What Happens During an Eye Injection?

The procedure is brief and is performed in the consulting room — no theatre, no general anaesthetic, no overnight stay.

• Anaesthetic drops are applied to numb the surface of the eye
• A small amount of local anaesthetic may also be placed under the conjunctiva to ensure the injection itself is as comfortable as possible
• The eye is cleaned carefully with antiseptic to minimise infection risk
• A small speculum may be used to keep the eyelid open
• The injection itself takes only a few seconds

You will be aware of the procedure — you may feel pressure, movement, and brief touch — but you should not feel significant pain. Most patients are surprised by how controlled and quick the experience is.

Do Eye Injections Hurt?

This is the question almost every patient asks before their first injection. The honest answer is that most people feel pressure rather than pain, and that the experience passes very quickly.

The anticipation is usually the hardest part. Once the anaesthetic has taken effect and the procedure begins, patients routinely find it far less distressing than they had imagined.

With repeated treatments, familiarity with the procedure makes it easier still. Many patients describe their injection appointments as routine within a few visits.

What Happens After an Eye Injection?

It is common to notice mild grittiness, irritation, or watering for a few hours after the injection. Vision may be temporarily blurred, and you may see a small bubble or floater in your vision immediately afterwards — this is the medication and resolves on its own within a day or two.

Most patients can resume normal activities the same day, though it is sensible to arrange a driver for your first appointment until you know how your vision is affected by the dilating and anaesthetic drops used beforehand.

What Are the Risks of Eye Injections?

Serious complications from intravitreal injections are uncommon, but it is important to know what to watch for.

• Infection (endophthalmitis) — the most serious risk, though rare. Symptoms are increasing pain, worsening redness, and reduced vision in the days following injection. This requires urgent assessment — do not wait for your next scheduled appointment if these symptoms develop.
• Inflammation — the eye may become red and irritated after injection. Mild redness is normal; significant pain or reduced vision is not.
• Raised eye pressure — can occur temporarily after injection and is monitored where clinically indicated.
• Transient floaters — common and usually resolve quickly.

If you experience increasing pain, significant redness, or worsening vision after an injection, contact the rooms immediately or present to Sydney Eye Hospital emergency if after hours.

How Often Do You Need Eye Injections?

Injection treatment is ongoing rather than a one-off procedure. Some patients require injections every four weeks initially, with intervals extended as the disease stabilises. Others may continue to be stable after extending to longer intervals. The schedule is reviewed at every appointment based on what the OCT scan shows.

Dr Hunt's research through the Fight Retinal Blindness! registry has shown that consistent treatment with appropriately adjusted intervals — rather than under-treating or stopping prematurely — is one of the most important factors in preserving vision long-term. These insights inform every treatment decision made in the consulting room.

Medications Used

Several anti-VEGF medications are available. The choice depends on the condition, treatment response, and current evidence. Newer longer-acting agents can extend the interval between injections for suitable patients.

• Aflibercept (Eylea, Eylea HD)
• Faricimab (Vabysmo)
• Ranibizumab (Lucentis)
• Dexamethasone implant (Ozurdex) — used in selected cases, particularly where inflammation is a significant component

How Long Do You Need Eye Injections For?

Most retinal conditions treated with injections are chronic — the underlying disease does not go away, and ongoing monitoring is important even when vision has stabilised. For some patients, treatment intervals can be extended substantially over time. For others, more frequent treatment remains necessary to maintain control.

The goal is to preserve as much vision as possible for as long as possible. Stopping treatment without medical advice — even when things seem to be going well — carries a risk of the condition reactivating. This is something discussed in detail as part of the ongoing care relationship.

Frequently Asked Questions — Eye Injections

Do eye injections hurt?

Most patients feel pressure rather than pain, and the procedure passes very quickly. Anaesthetic drops are applied first, and a small amount of local anaesthetic may also be placed under the conjunctiva. The anticipation is usually the hardest part — once the procedure begins, patients routinely find it far less distressing than they had imagined.

How often do you need eye injections?

Some patients require injections every four weeks initially, with intervals extended as the disease stabilises. Others may continue to be stable after extending to longer intervals. The schedule is reviewed at every appointment based on what the OCT scan shows. Consistent treatment with appropriately adjusted intervals is one of the most important factors in preserving long-term vision.

What happens after an eye injection?

It is common to notice mild grittiness, irritation, or watering for a few hours after the injection. Vision may be temporarily blurred, and you may see a small bubble or floater that resolves on its own within a day or two. Most patients can resume normal activities the same day, though it is sensible to arrange a driver for your first appointment.