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Treatments

Injection of Intraocular Drugs

The injections are given into the white of the eye with a very fine needle. Most people are frightened at the thought of an injection into the eye, but the actual experience is very mild. Most patients have no pain at all; when discomfort occurs, it is usually a gentle cramping sensation that passes within seconds. It is not uncommon for the eye to be very bloodshot for several days and have mild irritation for 24 hours. As with all medical procedures, intra-ocular injections carry a small risk of complications. Potential rare complications include cataract, bleeding, and infection, but steps are taken to prevent these complications, and less than one in 500 injections are associated with problems. If, at any time after an injection, you experience significant pain (pain not relieved by Tylenol or ibuprofen), or severe vision loss (that is, much worse than before the injection) call your doctor immediately.

Anti-Angiogenic (Anti-VEGF) Treatment

VEGF (Vascular Endothelial Growth Factor) is a chemical made by the body that is critical in causing abnormal blood vessels to grow under the macula in Wet AMD and leakage in some other conditions like retinal vein occlusions and diabetic retinopathy. Recently scientists have developed drugs that can block the action of VEGF. Blocking VEGF can stop the growth of vessels and, very importantly, reduce or stop the leakage of blood and fluid. This can lessen vision loss and, in some cases, partially restore vision that has been lost.

Anti-VEGF drugs include Avastin, Lucentis, and Macugen.

These drugs are administered by injection. Because the drug effects are often temporary, many patients need to have periodic injections to achieve the greatest benefit.

Kenalog

Kenalog is a long-acting anti-inflammatory drug related to cortisone. Like anti-VEGF treatment, Kenalog can be injected into the eye to reduce the damage caused by Wet AMD. This drug is usually not used by itself. More often, Kenalog is combined with laser, PDT, or anti-VEGF therapy to enhance or prolong the treatment effect. While definitely helpful in some cases, Kenalog must be used with caution, as it can cause cataract and, temporarily, increased intra-ocular pressure, which could lead to glaucoma.

Antibiotic and Antifungal Drugs

Endophthalmitis can sometimes be treated in the office with injection of antibiotic drugs into the eye. In more severe cases this is combined with a vitrectomy. Endophthalmitis is a very serious problem and blindness can sometimes result in spite of optimal treatment.