Over the last decade, the way that we treat wet macular degeneration has been revolutionized!
Many of us know someone whose vision has been affected by macular degeneration. My great-aunt, for example, suffered for years with severely decreased vision that was a result of the scarring and bleeding of wet macular degeneration. Unfortunately, her symptoms developed at a time when ophthalmologists did not have the types of treatments are available today.
What has changed that makes wet macular degeneration more treatable these days?
Over recent years, medical science has discovered that the severe findings of macular degeneration (bleeding, swelling, or scarring) are caused by a chemical called VEGF (vascular endothelial growth factor). This is also discussed in my first article on macular degeneration (click here for that page).
Ophthalmologists are now able to offer treatments that target the harmful effects of VEGF. We do this by applying medication exactly where it is needed – in the eye itself. The medicine is delivered to the eye through an injection with a small syringe and even smaller needle.
Injections in my eyes – are you serious?
Yes, quite serious!
As unusual as it may sound, our ability to inject therapeutic medications directly into the eye has substantially improved our ability to care for patients with macular degeneration. This means that people with this condition are more likely to have better vision and less disability.
Having performed these procedures for years, my experience has been that patients are often nervous before the first treatment because they don’t know what to expect. Once the injection is finished, they generally report that the experience was not as painful as they feared. On multiple occasions a patient has asked, “When will the injection happen?” a few moments after the procedure has already been completed! They are shocked to find that they are already finished.
Will my vision get better with these eye injections?
As with anything in medicine, every patient will respond to treatment differently. I always explain that we have three main goals with these injections:
- We need to prevent the vision from getting worse!
- We want to preserve the vision that we have now.
- We hope to improve the vision by reversing the changes that have occurred in the eye.
From experience, I’d say that most patients do see an improvement in vision after undergoing this therapy. But again, every patient presents with unique findings that will influence the success of the treatments.
How many injections will I need?
There is not a strict protocol that determines how many treatments a person will need, but it is safe to assume that most patients will receive more than one eye injection. Research studies clearly show that repeated treatments lead to better vision. Just like your car needs routine maintenance once in a while, it is now understood that macular degeneration patients have better outcomes if their eyes are treated every so often.
How is an eye injection performed?
To start, I use two different types of numbing medicine to limit the pain of the injection. Next, I clean the eye thoroughly with a betadine solution. A small wire spring is then applied to keep the eyelids open for the procedure. I measure the location of the injection and then apply the treatment to that site. The amount of medication injected is about the same as one eye drop from a bottle, and the needle on the syringe is among the thinnest that is manufactured. The procedure from start to finish takes less than five minutes.
What types of medication do you inject?
Currently I am offering the three medications that have been well-studied in ophthalmology. The names of these drugs are:
- Avastin® (bevacizumab)
- Lucentis® (ranibizumab – click here for the company website)
- Eyelea® (aflibercept – click here for the company website)
The Avastin that I use is a generic medication that is compounded from an accredited pharmacy. Lucentis and Eylea are sold commercially from the manufacturer. If you need a treatment with one of these medications, we can discuss which one is right for you. Sometimes we may try one of these medications first, then switch to another, if we feel that a different drug may lead to improved results.