In-Office Procedures
Intravitreal Injections
24-48 Hour Post-Injection Expectations
In the hours after your intravitreal injection your eye may feel “gritty”, like you have dirt or sand in it, and you may experience some tearing, mild soreness, burning, and/or irritation. Your doctor may apply an antibiotic ointment immediately after the procedure to alleviate symptoms. After 24-hours, symptoms should be 50-70% resolved and almost fully back to normal within 48-hours.The eye patch applied to your eye should be kept on temporarily for 2-3 hours post-procedure to avoid abrasion or accidental rubbing, and to keep the ointment on if we applied it. Once the patch is self-removed you can use an over-the-counter lubricant eye ointment and/or artificial tear drops to soothe your eye.
Your retina specialist may check your intraocular pressure (IOP) following the injection. There is a temporary rise that usually returns to baseline in a few minutes. The IOP may take longer to normalize in patients with glaucoma and needs to be monitored.
Other Normal Symptoms
- Floaters: drifting spots or specs in your vision; black, gray, or transparent strings, shadows, or cobwebs. These floaters are usually tiny air bubbles the syringe creates that are impossible to eliminate, even in the most experienced hands.
- A localized red spot or patch on the surface of the eye. This is where the needle punctured a blood vessel causing a small bleed or subconjunctival hemorrhage; this usually heals within a week.
- DON’T rub your injected eye.
- DON’T wash your face or shower for 48-hours.
- DON’T swim the week following.
- DON’T miss your follow-up appointment(s).
- DON’T wear contacts for the rest of the day.
- Follow your physician’s specific instructions for follow-up injections or course of injections.
- You may continue to use your regular over the counter or prescription eye drops as needed. We suggest using a fresh bottle of drops for the injected eye to avoid infection.
- Usually there are few, if any, physical restrictions. Please, consult your doctor to confirm.
Severe complications are very rare with intravitreal injections. If any of the following conditions occur after 48-hours, please contact our triage team as soon as possible, as these can be warning signs of a complication:
- Sensitivity to light
- Significant eye pain or swelling
- Blurred vision or reduction in sight
- A bright red eye
- Floaters or flashes that are getting worse or a dark shadow or curtain from above or below
- A rare but important warning sign is a milk-like fluid level in front of your iris.
The major risks are:
- Infection in the eye or endophthalmitis
- Inflammation in the eye or pseudoendophthalmitis (a non-infectious, inflammatory reaction to some medications)
- Bleeding into the vitreous gel (vitreous hemorrhage)
- Retinal detachment
The answer is yes, you’re OK! After an injection, it is normal to develop what is called subconjunctival hemorrhage, a red spot that develops on the white of the eye. This type off hemorrhage is essentially a painless bruise in the eye. You may not know you have it until you look in the mirror.
Subconjunctival hemorrhages can be caused by something as simple as a sneeze or rubbing your eye. Briefly, your blood pressure spikes in your veins and can cause capillaries to break. Rarely, subconjunctival hemorrhage is caused by a blood clot or other underlying issue.
A subconjunctival hemorrhage heals on its own without treatment, within a few days to a few weeks depending on the size of the “bruise”.
If your eye feels irritated, you may use artificial tears to alleviate the pain.Below is an example of a subconjunctival hemorrhage:
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Laser Procedure
- It is normal to experience blurred vision immediately after and up to a few hours after retinal laser surgery. In addition, your eyes will be overly sensitive to light because your pupils will remain dilated for up to 4-6 hours after administration of eye drops. Some patients may remain dilated for up to 24 hours, depending on the dilation strength used and individual reaction. You may experience aching inside or around the eye, itching, teary or watery eyes, and/or hazy vision. Typically, these symptoms will resolve themselves by the next day but can continue for a few days depending on your treatment.
- Tylenol, Ibuprofen, or any over the counter pain reliever is recommended, unless you are unable to consume for other medical reasons. We recommend ample artificial tears for comfort. Avoid rubbing your eyes post-procedure to avoid a corneal abrasion.
- Your vision may be blanched out (dark) for a few minutes after the procedure and you may see assorted colors or be light sensitive. Sunglasses are recommended, especially outdoors. There are no restrictions unless your laser was to treat a retinal tear or detachment. Usually, it takes 2-4 weeks for the laser to mature. During this time, we advise you limit any heavy lifting or strenuous or jarring activities.
- As light exposure won’t have any adverse effect, you may want to limit direct sun exposure if you are light sensitive from dilation.
Yes! You will be asked to return to our office for a follow-up visit with your physician within a few days after your procedure to ensure your eyes are healing correctly and no infection is present. Please don’t skip this!
That depends. Sometimes it can take weeks to months before your physician can determine how successful your laser treatment has been. Many patients do require more than one treatment to manage their eye condition and to prevent further deterioration of their vision.
Symptoms should gradually improve in the weeks post-treatment. If at any time you have a sudden burst of new or worsening floaters or flashing lights, sudden decrease or change in vision clarity, experience peripheral shadows, resembling a curtain or veil, signs of an eye infection, or any pain or discomfort not alleviated with OTC pain medication or artificial tears, please call our office immediately at 303-261-1600 and follow the prompts to speak with a member of our “triage” team. For ocular emergencies, we have a trained Colorado Retina technician and surgeon on-call after hours, weekends, and holidays.
Cryotherapy
Cryotherapy or cryopexy is a means of freezing the area of the retina where a retinal tear has occurred. It is a procedure that uses intense cold to induce a retinal scar around the tear. The scar acts as a kind of glue to heal the tear in the retina. It then takes around 10 to 14 days to heal. Early detection of retinal tears is crucial to the success rate of the procedure. If left untreated, a retinal detachment may occur.
Your CRA physician will decide which procedure, laser or cryotherapy is the right option to treat your retinal condition.
Cryotherapy is a same day procedure performed in a clinical setting in our office. First, a topical anesthetic will be placed on your eye, followed by a subconjunctival injection (under the eye or lid) of a local anesthetic. A tool called a cryo probe is then placed on the outside of the eye over the area of the retinal tear. The probe is turned on and a small area of the eye is frozen in a few seconds. Several areas will need to be frozen to seal the tear.
You may experience a brief sensation like having an “ice cream headache” or “brain freeze”, but the procedure is painless and usually takes no longer than 10 minutes to complete.
- This is an outpatient procedure, so you go home the same day.
- Your procedure eye will be patched at or office. That patch should remain on for a few hours to avoid rubbing and debris.
- After the procedure is performed, mild redness, swelling, dry eye, and/or discomfort can be expected. You may take an over-the-counter pain reliever, acetaminophen (Tylenol) is recommended.
- Changes in vision clarity, as well as halos, starbursts and glares when looking directly at light are also normal.
- Healing will occur within 10–14 days. Vision may be blurred briefly, and the repaired eye is usually red and swollen for a short period of time.
- Once the patch is removed you may lightly use a cold compress on your eyelid to alleviate discomfort.
Early treatment is key to the effectiveness of cryotherapy, and the procedure almost always improves vision quality. In retinal tears and detachments, the retina can be repaired and reattached in most cases. Some patients may need additional cryotherapy procedures when there is extensive retinal damage.
Following cryotherapy, if you experience a black curtain in your field of vision, complete or rapid loss of vision, or increase in spots/floaters, strands, or cobwebs, please call our office at (303) 261-1600 immediately and follow the prompts to speak with a member of our triage team.