Questions about injections

Hearing that you need eye injections can be frightening. But you're not alone in feeling nervous or unsure.  

The good news is that most people say injections aren’t as painful as they expected. 

For thousands of people with macular disease, injections are a regular part of treatment and can be vital in preserving your sight. 

This page will walk you through what to expect before, during and after an eye injection.  

Whether you’re preparing for your very first appointment or feeling anxious about ongoing treatment, you’ll find helpful guidance and reassurance here.  

What are eye injections and how do they work?

The current treatments for conditions like wet age-related macular degeneration (AMD), diabetic macular oedema (DMO), and retinal vein occlusion (RVO) need injections into the eye (intravitreal injections).  

These injections, often referred to as Anti-VEGF injections, work by slowing or stopping the growth of abnormal blood vessels in the eye that can cause rapid sight loss. 

VEGF is a substance produced in the body that helps the growth of blood vessels. In many eye conditions, too much VEGF causes the growth of abnormal blood vessels. These blood vessels leak and damage your vision. 

Anti-VEGF injections block VEGF. This helps: 

• Reduce swelling in the retina 
• Stop blood vessels from leaking 
• Slow down or stop the loss of vision 
• The injections prevent further vision loss in up to 90% of people. 

Some specific Anti-VEGF names are aflibercept, ranibizumab or faricimab. You can read more about the different Anti-VEGF drugs on the treatment page. Your eye specialist will decide on the most suitable drug for you. 

How do I make a decision on whether to have injections?

It can be confusing to know what the best course of action is when you have been given a diagnosis. A lot of people will want more information before they decide to start treatment.  

If you would like help on making your decision, take a look at the NHS’ useful decision aid for those with wet AMD. 

Who should not have eye injections?

If you are pregnant or planning to become pregnant, you should discuss this with your doctor before starting eye injections. It’s usually advised that eye injections are delayed until after pregnancy. If you find you are pregnant whilst you are undergoing a course of eye injections, speak to your doctor. They may advise you not to have eye injections while you are breastfeeding as we do not currently know if the medicines pass into breastmilk.  

You should also not have eye injections if you have a severe infection or any infection in your eye. 

How many injections will I need?

Each person reacts differently to eye injections. The number of injections you will need can vary depending on your condition and how well you respond to the drug. 

You will typically start with injections every month for 3 or 4 months, called the ‘loading dose’. After the loading dose, eye care professionals will try to increase the time between injections.  

For some, this will be enough and they will not need any more. Others may require injections for many years. This is called the ‘maintenance phase’ and usually involves injections every 6-8 weeks depending on how well your eyes respond.

There are two main reasons injections may stop: 

• Vision becomes stable, and treatment is no longer needed  
• Vision continues to worsen and having more injections would not help you to see better.  

How do doctors decide when I next need an injection?

Most people will have an Optical Coherence Tomography (OCT) scan at each appointment. This quick scan will give your eye specialist detailed images of the back of your eye. They will be able to see 

Where the swelling and fluid leaks are 

How well treatment is going after each injection 

Depending on what they see on the scan, you might not need an injection every time you visit. If treatment is going well, you might move on to a “treat and extend” plan. This means that if your eye is stable, you can increase the time between injections.  

Tips for your appointment

It’s normal to feel anxious before an appointment, so knowing what to expect should help you feel more in control.  

• It’s fine to eat and drink as normal before the appointment 
• You might want to bring someone with you for support – at least for the first appointment 
• Some waiting is usually expected, so bring something to entertain you while you wait.  
• Eye sensitivity after an injection is normal, so bring sunglasses to wear home 
• Tell the staff if you’re feeling worried and they can talk you through things and provide reassurance 

What to expect during the procedure

You’ll usually be seen in a hospital eye clinic by an ophthalmologist or trained nurse. You may need some tests before you have your injections and how long this takes will depend on what tests you need.  

You may have a scan before your injection for the eye specialist to evaluate how treatment is going. 

The appointment for an injection typically takes around 1-2 hours, but the injection itself is very quick – just a few seconds. 

Step 1 – numbing the eye 

Before the injection, the eye is numbed with local anaesthetic, so you won’t feel any pain. 

Step 2 – cleaning the eye 

Your eye and eyelids will be cleaned with a disinfectant called povidone iodine (brand name Betadine) to stop any infection developing. 

Step 3 – the injection 

The medication is injected directly into the eye. This takes the medicine straight to the affected area and helps to preserve as much vision as possible. 

Step 4 – after the injection 

Your eye may be checked before you go home and you’ll be asked how you feel before you leave. 

While it might sound daunting, this is a well-established treatment that’s used safely every day across the UK. Most people tolerate the injections well and don’t have any problems afterwards. 

Do eye injections hurt?

Understandably, many people worry about pain, but most find the procedure far less uncomfortable than expected.  

Thanks to the numbing drops, you shouldn’t feel the needle itself, although you might feel some pressure or a slight scratch. 

Some people experience mild discomfort or a gritty feeling afterwards, which usually passes within a day. If you’re concerned about pain during or after the procedure, speak to your eye care specialist, as they’re there to help. 

Although an allergic reaction to iodine is rare, some people find that it causes irritation to their eye or skin. If you experience discomfort or pain after injections, tell your specialist or nurse. They may use a different local anaesthetic, saline or lubricant drops. 

If none of these changes help, they may talk to you about using a different antiseptic called chlorhexidine, which doesn’t contain iodine.  

How successful are eye injections for macular disease?

Anti-VEGF injections are the most effective treatment for wet AMD and DMO. 

Around 9 out of 10 patients maintain their level of vision after a year of treatment. Some people will notice improvement, but the aim of treatment is to stop your vision from worsening. 

If you need eye injections, it is very important that you get them on time and don’t miss any appointments. Delaying your treatment can mean that your sight gets worse.  

Are there any side effects or risks?

Complications and side effects from eye injections are rare, and most people have no problems. But there are some things to watch out for. 

Common, mild effects that do not last long: 

• A gritty feeling in the eye 
• Slight redness 
• Temporary floaters in your vision (small moving spots) 
• Rare but more serious complications: 
• Infection in the eye (called endophthalmitis) 
• Retinal detachment 
• Bleeding 

These complications are rare, but it’s important to follow any aftercare advice from your clinic.  

What happens after my injection?

The effect of the local anaesthetic normally lasts for about half an hour. There may be a bit of discomfort when the anaesthetic wears off, but this is usually mild. 

Different hospitals will give different advice, so make sure you follow the recommendations given by your own clinic. 

You’ll usually be able to go home soon after the injection. Your vision may be blurry for a few hours, and you may see some floaters or black spots, which is completely normal. Try to rest your eyes and avoid rubbing them. You should only drive when you feel safe to do so and your vision is clear. Most people will wait until the next day, but follow the advice given to you by the clinic. 

For a few days after injections, your clinic may advise you to avoid: 

• Getting water into your eye 
• Wearing eye make-up 
• Swimming 

You can usually fly after an injection but it’s best to wait a day or two, in case you have any complications and need urgent care.  

If you develop significant discomfort or severe pain in the eye about one hour or more after the injection, it can be due to corneal abrasion: a scratch on the cornea (the clear glassy part of the eye). 

The injection can also cause the eye to become very dry. This may result in the eyelid sticking to the eye and damaging it. Dry eye gel can be used to prevent this from happening after future injections. Always check with your eye care professional before using any product. 

Try not to rub your eye too much after an injection, as it may make an abrasion more likely - especially as you won't be able to feel it while the eye is still numb. 

Support and living with ongoing treatment

It can be frightening knowing that you need injections into your eye. And travelling to the hospital can also take a lot of time and organisation, especially if you live in a remote area. Lots of people feel anxious or worried about this treatment, especially at first.  

If you are worried about it, you can get support. We have information to help you with your mental health. And you can access our support groups, helpline, or counselling if you need them.  

Speak to a Macular Society treatment buddy 

Knowing others have faced the same fears – and come through them – can be incredibly reassuring. That’s why we connect you with real people who understand what you’re going through. 

Our Treatment Buddy service matches you with someone who has personal experience of eye injections for macular degeneration. Whether you're preparing for your first treatment or struggling with ongoing appointments, a friendly chat with someone who understands can make a world of difference. 

Who the befriending service is for: 
Anyone feeling anxious, isolated or simply curious about what to expect. 

How it works: 
You’ll be matched with a volunteer who has had similar treatment. You can chat by phone or email – whatever feels most comfortable for you. 

93% of people who used our Treatment Buddy service said it helped reduce their anxiety around injections. 

What others say about eye injections 

“To anyone who is fighting against having an injection, I'd say there's no need to be fearful.” – Hazel, Macular Society Treatment Buddy volunteer 

“The staff are always so kind and considerate and tell you step by step what they’re going to do. The whole procedure doesn’t take long.” – Merle 

“If it weren’t for the injections, I’d probably be blind by now.” – Pamela  

“Having a support system is important. My family helps me get around, and having someone with you at the appointment can ease the process.” – Brian  

FAQs

How many injections will I need for macular degeneration? 

Most people start with 3-4 monthly injections, then move to less frequent treatments depending on how well their eyes respond. 

How often will I need eye injections?  

Initially, injections are usually once a month. After the first few, your specialist may extend the time between appointments.  

How successful are eye injections for macular disease? 

Eye injections are very effective — around 9 in 10 people keep their level of vision, and some even see improvement. Without them, vision would decline over weeks or months. 

Do eye injections hurt?  

Most people feel little to no pain thanks to numbing drops. You may feel slight pressure or mild discomfort, which usually passes quickly.  

What are the side effects of eye injections?  

Mild soreness, redness, or floaters are common and temporary. Contact your clinic urgently if you have severe pain, swelling, or sudden vision changes.  

What happens if I miss an injection appointment?  

Try not to miss injections, as it can affect your sight. Call your clinic as soon as possible to rearrange.  

Can I return to work the same day after my injection?

Most people can return to light activities, including work, the same day. Your vision may be slightly blurry, so avoid tasks that require sharp focus immediately after. 

Can I drive after an eye injection? 

You should only drive when you feel your vision is clear and you feel safe to. For most people, this is the next day, but make sure you follow the advice of the clinic. 

How soon will I notice a difference in my vision? 

Some people notice improvement after the first few injections, while others need several treatments before seeing a change. Some people may not notice an improvement in their vision, as injections aim to stop or slow vision loss.  

Is there any financial support available for travel to appointments? 

Yes, you may be eligible for help with travel costs through the NHS Healthcare Travel Costs Scheme. Contact your clinic for details. 

What support is available if I feel anxious about injections? 

Anxiety is common. Talk to your clinic team, or contact the Macular Society helpline for free counselling and support. 

Are new treatments being developed? 

Yes – researchers are working on longer-lasting injections, eye implants, and gene therapies to reduce the need for frequent appointments. 

Are there alternatives to eye injections?

Eye injections are the only approved treatment for AMD, and the most used treatments for other macular conditions like DMO. We know that eye injections can be scary, but without these treatments you are more likely to permanently lose vision.  

There is research ongoing to find longer acting treatments or  gene therapies to limit the number of injections needed. 

Last review date: April 2026
Next review date: April 2028