Shortening Ocular Pain Duration following Intravitreal Injections

Abstract

Purpose. To determine ocular pain duration after routine in-office intravitreal injection and to determine whether topical eyedrops are beneficial in increasing patient comfort. Methods. Forty injection-naïve patients receiving routine intravitreal injections of bevacizumab for age-related macular degeneration were randomized into 3 groups: group 1 (control, no drops), group 2 (generic artificial tears), and group 3 (ketorolac tromethamine 0.4% eyedrops). Those who received topical medications were given a Visual Analog Pain score survey and asked to record their pain on a scale from 0 (no distress) to 10 (unbearable distress) daily until a score of 0 was achieved, at which point they were instructed to discontinue use of their given drops. Self-reported pain scores were assessed. Results. Pain after routine intravitreal injection lasts on average between 3 and 7 days. Patients receiving topical ketorolac eyedrops reported the fewest average number of pain days (2.25±1.22) vs patients receiving artificial tears (3.54±1.13) or those who received no postprocedure eyedrops (5.13±1.25); p<0.05. At most, patients receiving ketorolac eyedrops reported 3 days of recordable pain. Those who received artificial tears reported at most 5 days of recordable pain, and patients who did not receive any postprocedure eyedrops reported at most 7 days of recordable pain. Conclusions. Pain after intravitreal injection is generally mild, may be reduced by postinjection topical ketorolac eyedrops, and lasts less than 1 week.

Which quadrant is less painful for intravitreal injection? A prospective study

“…There was no statistically significant correlation between patient age and VAS score (p = 0.659). To find any correlation between patients age and injection pain based on previous studies [26], the patients were divided into two age groups: >65 and ≤65 years old. No correlation was found between pain scores and age categories (p = 0.659).…”

“…Several factors have been reported to be associated with pain during intravitreal injections, such as anxiety [29], sex, number of previous injections, age [30], ketorolac eye drops [26], needle size [20], and anesthetic technique [31].…”

Needle size in intravitreal injections – pain evaluation of a randomized clinical trial

“…; Moisseiev et al. ; Rifkin & Schaal ,b). The standard anaesthesia at our hospital according to national guidelines is the use of topical 0.5% tetracaine.…”

Evaluation of pain during intravitreal Ozurdex injections vs intravitreal bevacizumab injections

“…Pain associated with intravitreal injections is generally mild, and mean VAS scores reported in previous studies during these injections varied from 12 to 35. 17,30,31,[35][36][37][38] A previous study performed in our department regarding pain sensation associated with intravitreal injections of bevacizumab includes the largest series (218 patients) published to date. 17 No correlation was found between pain and age, sex, indication for injection, number of previous injections, presence of DM, and lens status.…”