67028 Intravitreal injection of a pharmacologic agent (separate procedure)

Intravitreal Injection of a Pharmacologic Agent

Name of the Procedure:

• Common Names: Intravitreal Injection, IVI
• Medical Terms: Intravitreal Injection of a Pharmacologic Agent

Summary

An intravitreal injection involves delivering medication directly into the vitreous humor—the gel-like substance inside the eye. This method ensures that the medication reaches the back of the eye where it can be most effective.

Purpose

• Condition Addressed: Used to treat various eye conditions such as age-related macular degeneration (AMD), diabetic retinopathy, retinal vein occlusion, and eye infections.
• Goals: The objective is to administer drugs directly to the site of the issue in the eye, which allows for higher drug concentrations at the target area with minimal systemic exposure.

Indications

• Symptoms or Conditions: Blurred vision, vision loss, retinal swelling, bleeding within the eye.
• Patient Criteria: Recommended for patients diagnosed with specific retinal conditions such as AMD, diabetic macular edema (DME), and certain types of eye infections.

Preparation

• Pre-Procedure Instructions: Patients may be advised not to wear makeup. They should inform their doctor of any medications they are taking and follow specific instructions about eye drops if provided.
• Diagnostic Tests: Comprehensive eye examination and imaging tests such as optical coherence tomography (OCT) may be required.

Procedure Description

1. Anesthesia: Local anesthetic drops are applied to numb the eye.
2. Cleaning: The eye and surrounding skin are cleaned with an antiseptic solution to prevent infection.
3. Speculum: A small device may be used to keep the eye open.
4. Injection: The medication is injected using a thin needle directly into the vitreous humor.
5. Aftercare: Eye drops may be applied to prevent infection and reduce inflammation.

Duration

• The procedure typically takes about 15-30 minutes.

Setting

• Performed in an outpatient clinic or an ophthalmologist's office.

Personnel

• Performed by an ophthalmologist with the support of a nurse or medical assistant.

Risks and Complications

• Common Risks: Mild discomfort, redness, floaters, temporary increased intraocular pressure.
• Rare Complications: Infection (endophthalmitis), retinal detachment, vitreous hemorrhage, cataract formation.

Benefits

• Expected Benefits: Improved or stabilized vision, reduction in disease progression.
• Realization Time: Benefits often realized within a few days to weeks, varying by condition and medication used.

Recovery

• Post-Procedure Care: Use prescribed eye drops, avoid rubbing the eye, wear an eye patch if instructed, and attend follow-up appointments.
• Recovery Time: Generally, patients can resume normal activities within a day, though specific instructions regarding any restrictions will be provided.

Alternatives

• Other Treatments: Oral or topical medications, laser therapy, surgical interventions.
• Pros and Cons: Alternatives may involve different risk and efficacy profiles. IVI provides a high concentration of medication directly to the problem area with quicker and more specific effects.

Patient Experience

• During Procedure: Some discomfort may be felt, but it is generally well-tolerated due to local anesthesia.
• After Procedure: Mild soreness, floaters, or irritation may occur; pain is usually minimal and manageable with over-the-counter pain relief if needed.

This detailed overview covers everything a patient needs to know about the intravitreal injection of a pharmacologic agent, from preparation to recovery.