"My First Avastin Injection:" A Patient Account

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"My First Avastin Injection:" A Patient Account

A patient's account of the his first intravitreal injection of Avastin and the weeks that followed. It is interesting to see how fast he started to notice a change.

A couple of months ago, I examined a new patient who had been complaining of decreased vision, and distortion, in the right eye for about 2 months.  His vision was 20/200 in the right eye.  After examination, I recommended  Avastin® treatment for his wet macular degeneration.  This is his account of the injection and the weeks after.

Saturday, 12/5 I was administered the shot of Avastin at about 12:49 pm. I was first given about 4 Q-tips of topical anesthetic. The Avastin was then administered. I felt no pain when the needle entered, but I felt a not-too-s pressure. Soon thereafter, I suspect when the drug was “pushed’ out of the syringe, I did feel slight pain for about 1 second or so.. The fact that I felt some pain worried me, more that the slight pain itself, likely because of where and how I felt it….a NEEDLE in my EYE, knowing I couldn’t move. The pain disappeared immediately after about 1 second. After the needle was removed, I felt no pain whatsoever. Soon after leaving the office, I felt a significant irritation in my eye, similar to what one would experience with a more than mild seasonal allergy. There was slight burning, but NOTHING what one might say would approximate any kind of pain, For the next few hours it persisted, then it went away. Perhaps it was because of a post-procedure antibiotic. The rest of the day my eye was irritated, but nothing more that the feeling one might have when the eye is scratched when taking out a contact. I did feel some slight pressure/swelling of the eye afterwards, throughout the day, but, again, no pain. I went to bed at about 11:45 pm on Sat.

Sunday, 12/6 I woke up on Sunday at about 8:30, My eye felt normal. I did not have a contact lens in the subject eye since the night of Friday, 12/4. I looked in the mirror, and it visually appeared to look normal. I got my act together, then went downstairs. I closed my good eye, to see how the subject eye was performing. Without considering the distortion issue which brought me to Dr. Wong, the “clarity” of vision in that eye “seemed”, and “seems”, noticeably improved, without my contact in. Lines seem more defined and crisper.

As to the distortion, my sense is that it is already improved, although it is still definitely present. I note, however, that it seems less “bothersome” to me on a minute-by-minute basis. I am writing this shortly thereafter…at 9:36 a.m….only 21 hours after the procedure that administered the drug. It is possible that my perception is psychological, or that it is difficult to judge comparatively since my eye was irritated until I went to bed last night, but my “sense” is that the distortion is actually improved from the starting point. Overall I would rate my vision in the subject eye as already being better than before I underwent the procedure.

Monday, 12/7 Upon wakening this morning, and for 2 hours thereafter, I noticed no change in my vision from Sunday.

Tuesday, 12/8 I noticed no change in my vision an hour after my 6:00 a.m wake up

Wednesday 12/9 – 12/13 No discernable difference in my vision

Sunday 12/13 My impression is that there seems to be some slight improvement in the distortion, but it is not possible to accurately define.

Wednesday 12/15 I notice that I am able to read large type better than before, but small type is not possible. The distortion seems the same since yesterday

Saturday 12/19 In the shower this morning, I had the strong impression that my distortion is much better. There is still distortion, but it seems much less significant than before. When I close my left eye, there is what I feel is excellent clarity, but still some distortion.

Friday 1/1 I noticed in the shower that my distortion seems improved again. Things don’t seem as slanted with my right eye, as compared to my left eye (with right eye shut).

Friday 1/8 My impression is that the distortion is improved again, but it’s hard to explain “how”. I suppose, it’s just a bit less severe.

Wed 1/13 No discernible change…………

_______________________________________

Sat 1/23

Got another shot yesterday. They left the anesthetic on longer before the shot. I had no pain during the shot, but it was pretty uncomfortable. No big deal. The shot was quick. Had burning and watery eye for next 3 hours, then much better. Woke up this morning, and for the first ½ hour I forgot that I even had a shot yesterday.

Put the contact lens in about 9:30 am. All systems are go. Eye feels a touch tender, but a total non-issue.

I notice no change in my vision from before the shot yesterday.

****************************

What Does This Mean? The second shot was administered last Friday.  Vision had improved from 20/200 to 20/40 in just six weeks!  In all the literature, you never read anything from the patient’s perspective.  I find it interesting that my patient noted changes in the vision almost immediately and that these changes continued for the first month.  A third injection is planned in another 6 weeks.  I suspect that the vision will continue to improve, especially the distortion, based on the location of the neovascular tissue;  it is just to the side of the macula.  Once the nevascular tissue has regressed, additional injections may be needed for “maintenance.”

“Randy”

Randall V. Wong, M.D.
Ophthalmologist, Retina Specialist
Fairfax, Virginia

Comments
  • Libby January 25, 2010 at 11:39 am

    Very good patient perspective and rather simlar to my own experience. I have the Avastin for Macular Oedema but also have other problems affecting my vision, so any and all improvement I get following the injections is a bonus!

    For me the actual injection is only momentarily painful when the needle breaks through. Plenty of local anaesthetic drops are used so I don’t get too much irritation afterwards. The only thing I find quite uncomfortable (not painful) is the placement of the speculum used to hold the eyelids open.

    I do get some pain as a result of the increased pressure after the injections but I have other eye conditions that contribute to this.

    I have had going on for nearly 30 injections over 2 years (in both eyes) and now note that the improvement for me is most evident from about 4 days after the injection. I have certain ways of checking the improvements, if I can read the clock face at the other side of the room, make out wind turbines on distant hills to just using the computer with less magnification.

    I seem to have permanently lost the clarity for faces, road signs and license plates. Despite this, I have functional vision that still improves following the Avastin injections and I will continue having them as long as they do!

    Having the injections is nothing to endure in comparison to the near miraculous improvement to my vision. When things began to go badly wrong and the macular oedema was severe I thought I would go blind. Thanks to Avastin I haven’t!

    • Randall V. Wong, M.D. January 25, 2010 at 12:34 pm

      L,

      Thanks so much for taking the time to comment. There are several readers who share the same perspective.

      Cheers!

      Randy

  • Terry January 25, 2010 at 12:26 pm

    First off: Thanks for all the work you do for this site. I sincerely appreciate it.

    I, too, have been receiving Avastin injections for the past 2+ years due to a macular edema in my left eye. (Please note: I have Best Disease in my right eye). Each are administered every 4 to 5 weeks. Some thoughts and comments.

    The injections themselves are relatively painless. There is some pressure at times, depending on the anesthetic application/effectiveness. Given I have had about 23 injections so far, only about 2 of them would classify as painful. Pain like getting punched in the face. Short-lived, but seismic in its power – almost dizzying. I cannot see well out of the injected eye for the remainder of the evening (I do try to schedule my injections late in the day).

    For my first 20 injections, they were administered at about the 6 O’clock part of my eye, and have since moved to the 10 O’clock position. It has made recovery so much smoother, though anesthesia application is not any easier, at all. The anesthesia application is absolutely brutal. Having someone hold a Q-tip to your eye for any period of time is uncomfortable, but for minutes at a time – horrendous. The worst part of it all!!!

    The night of the shot, after the topical anesthesia wears off, is pretty uncomfortable. Akin to have something caught in your eye (for hours). Wetting drops, (along with the anti-biotic drops) come fast and furious. A sleeping pill has been a good friend those nights. Just makes it easier for a person who normally likes to sleep face down. The following morning brings a crusty eye to the mirror, but not bad at all. And it just gets better from there on out, thankfully.

    My visual acuity has been pretty spotty as we approach each injection, the floaters and blurred vision increase. My ability to see small type is greatly diminished. Vision is relatively quite good the day after the shot. Within 2-3 days after the injection, I am seeing totally fine again. That lasts for about 4 weeks, before the deterioration sets in, then back for another shot.

    I despise this process. It is not fun at all. Yet, my doctor’s staff makes it so much better than it could be. I have had many different people administer the anesthesia; some are much, much better than others. A little empathy goes a long way there. My doctor is the best, in so many ways. Honest, heartfelt caring and compassion makes an uncomfortable process, and scary subject (my vision) much, much better. I am very grateful and thankful for his care.

    • Randall V. Wong, M.D. January 25, 2010 at 12:35 pm

      T,

      Thank you so much for sharing your perspective. I have really this medium very much. Best of luck, thanks for contributing and please stay in touch!

      Randy

  • Cathy May 25, 2010 at 1:32 pm

    I also started injections with Aviston July 2009. I was 55 years old diagnosed with wet macular after 4-5 years of dry macular. 2nd injection was August 2009 and 3 days later I was blind with infection.
    Sept 2009 retina specialist had to remove my lens and December my retina detached. Doctor
    advised I needed to continue treatment in left eye or I would probably lose sight due to wet
    macular. Started Lucentis in Jan 2010 with no real change. vision in left eye is 20/300 to 20/400
    I suppose time will tell if this works for me. A real life change

    • Randall V. Wong, M.D. May 25, 2010 at 4:30 pm

      Cathy,

      Gut wrenching. How is your right eye? Thanks for sharing. I am sure it has been a very long year!

      Randy

  • Bridgette August 15, 2010 at 12:43 am

    I had my first injection today. The procedure was quick and painless. 10 hours from the injection, my eye is very irritated and scratchy. It is comforting to read the comments and know this is common. We shall see what tomorrow brings.

    • Randall V. Wong, M.D. August 15, 2010 at 2:51 am

      Bridgette,

      Best of luck to you! The scratchiness can be from some of the elements used to cleanse the eye in preparation for the injection (at least in my office).

      I hope everything works out for you.

      Stay in touch.

      Randy

  • Clark August 17, 2010 at 8:50 pm

    Just had my second AVASTIN injection in my right eye. Didn’t notice to much improvment after the first injection but we will see what happens.(pardon the pun). I did have the doctor tell me however that they “hit a blood vessel” with the injection this time and my entire eye is blood red and very scratchy. Kind of scary but hopfully all will improve. I am only 44 years old and have been type 1 diabetic for 28 of those years. I spent alot of my younger diabetic life not taking care of myself like I should have and am paying the price now. All of you diabetics, take care of yourselves.

    • Randall V. Wong, M.D. August 17, 2010 at 9:38 pm

      Dear Clark,

      I think the comment about “hit a blood vessel” pertains to the fact that a blood vessel OUTSIDE the eye was knicked and caused some pretty frightful, but benign, bleeding. A so-called subconjunctival hemorrhage is completely benign, but awfully bloody. It should go away, just like a bruise, in a week or two.

      My curiosity says that you received Avastin for diabetic retinopathy and NOT macular degeneration, correct?

      I applaud your challenge to the younger diabetic patients. Thanks for the comment. Look forward to hearing from you again.

      Randy

  • clark August 18, 2010 at 10:02 pm

    Thank’s for the quick reply
    I’m receiving AVASTIN injections for diabetic macular edema in my right eye. The vision is quite distorted and hopefully this treatment will help and stop the problem from getting worse. I’ve had extensive laser work done in both eyes for proliferative retinopathy and at this stage things seem to be stable as far as that goes.
    I did hear on the news just last night that the FDA is considering taking AVASTIN off the market. Is this just for the treatment of breast cancer? Or would it be taken off the market completely? It sounds to me like it has helped many people with macular edema.

    • Randall V. Wong, M.D. August 19, 2010 at 12:20 pm

      Clark,

      In my experience, it sometimes takes several injections to get a favorable response. Be patient. I have also had great success alternating with steroid injections.

      My sources say that the FDA pulled its approval for the treatment of breast cancer only. Avastin is still indicated for the treatment of other cancers, such as colon cancer.

      Stay in touch.

      Randy

  • Bridgette September 22, 2010 at 10:19 am

    Good morning, I had my second injection two days ago. I went from a 20/200 to 20/30 in one month. I am extremely happy with the results. But, I am losing a lot of hair, is that a side effect of the avastin? (and I am not complaining, losing some hair is nothing compared to my sight)

    • Randall V. Wong, M.D. September 22, 2010 at 10:54 am

      Dear Bridgette,

      I am very happy to hear of your progress. You must be elated!

      Regarding the hair loss, it has been a complaint, but usually in the scenario when given as a chemotherapeutic agent.

      I like your perspective, though.

      All the best! Thanks for the update.

      Randy

  • Lily October 6, 2010 at 9:43 am

    I had my first Avastin shot yesterday in my right eye. For 3 days before I used antibiotic eye drops, 1 drop 4 times a day; will continue those for 4 days after. It was totally painless! The longest part of the process was the prep. The eye was dilated, numbing drops applied, the eye was cleaned with betadine and then a Novocain shot. After a waiting period to allow total numbing, the Avastin was given. The shot could not have taken 2 seconds!

    The nurse then rinsed the eye for several minutes and applied the antibiotic eye drops. My eye felt very scratchy, apparently from the drying affect of the betadine. She applied artificial tears in a thick gel and told me to use that as often as needed; (waiting 5 minutes) if used after the antibiotic eye drops.

    I was told to bring someone with me to drive me home. Hubby went, but I could have driven home without a problem!

    For the remainder of the day, the right eye was sensitive to light and felt a bit tender at the shot site (that area was also a bit bloodshot) and continues that way this morning. As I was told, it took almost all day for the numbing to wear off. The eye felt a bit different but that was not bothersome at all. I was able to do whatever I wanted. I was told to not swim for 3 days. Thanks goodness it has cooled off here considerably this week and our pool temp is too cool for me…lol. So swimming is not an issue.

    My vision in this eye was just beginning to get a bit fuzzy and the MD was diagnosed a week ago. I am not going to proclaim any real change in the vision at this point because it had not negatively impacted my sight; it was just a concern. I am blessed and can still read small print with the right eye.
    I go back next Tuesday for follow up. At that time we will determine when to do the next shot. I have a wonderful retinologist, who is very current on all procedures. I have had laser treatments in both eyes due to large floaters. The left eye 2 years ago and the right 6 months ago. I don’t know what the outcome of all this will be; however, I will be pleased if the progression is stopped at this point.

    Please do not hesitate to use the Avastin or whatever your doctor recommends because of your fear of pain. Research your doctor, ask questions and make an informed decision. It is such a small dose of Avastin, there will be no hair loss. I saw that mentioned on one of the sites and questioned my doctor. He smiled and said it was a question every woman asks. No hair loss related to the shots. His office has done 15,000 Avastin shots and only had 13 infection cases. The “germ” that causes the infection is only found in the mouth, so he requires no talking during the procedure.

    I wish you all the best!!

    • Randall V. Wong, M.D. October 6, 2010 at 12:54 pm

      Lily,

      Thank you so much for sharing your perspective. Your encouragement is welcomed (and needed!).

      Thanks for the comments and I wish you all the best!

      Randy

  • ars November 10, 2010 at 10:31 pm

    After 27 Avastin and 3 steriods injections, edema keeps reoccuring every 5 to 6 weeks. Did anybody go thru similar experience? Any comments on use of implants?

    Thanks.

    • Randall V. Wong, M.D. November 10, 2010 at 11:47 pm

      ARS,

      I have a patient in England with whom I communicate via Twitter. I’ll reach out and see if she’d like to comment.

      Why are you getting the injections? Is it for diabetic retinopathy or something else?

      Randy

  • Libby November 12, 2010 at 1:38 pm

    Hello ARS

    I have had a similar number of Avastin Injections over the past 2 ye, although only one peri-ocular steroid injection. It was slower to improve things for me but not repeated in favour of the quicker, more effective Avastin.
    Most unfortunately the last two injections I have caused me to have a generalised reaction and there are fears I may got into anaphylatic shock if I have another. So I can have no more Avastin or other treatments of the same family of medication. The macular oedema is persistent and is gradually building up again and my vision deteriorating along with it.
    My Dr is looking into me having a bead or pellet of Dexamethasone (type of steroid) inserted into my eye/s, that will slowly release over a year. In trials it has shown to be quite effective in reducing and controlling the oedma over a longer epriod of time and eleminating the need for near monthly injections.
    I have few options remaining as I have also had Grid Laser performed with some effect but there is a limt to how much of that you can safely have.
    I am on the edge of my seat waiting to hear if I can indeed have the Dexamethasone pellet so the oedema can be reduced again and improve my detailed vision. In the UK getting treatments sanctioned both clinically and financially can be a lengthy process.
    Meanwhile, I am adapting to not seeing clearly at all, wearing the partially sighted ‘mantle’ but don’t let it get me down. I can still function using magnifcation and still use the computer very well with accessibilty features enabled. What ever it takes!
    When he first diagnosed Cystoid Macular Oedema, my Dr has always been candid with me about losing the clarity of my vision . He said he could give no promises about it being controlled for ever and said it varied from person to person. I have numerous other conditions of my eyes that compound the problem but feel the oedema has been the most frustrating.
    If I hadn’t developed a reaction I would continue to have the Avastin Injections as long as they made a difference that could be seen on the OCT scan.
    Has your Dr mentioned any other conditions that may be affecting your vision? I have cataracts forming that are making my vision worse and their removal may yet improve things for me ~ here’s hoping!
    If you have any specific questions, feel free to ask.

  • Harold December 30, 2010 at 5:24 pm

    I had an injection 8 days ago and there has been no change.
    The Dr. did not say I had wet macular degeneration but did say that
    there was blood vessel from the retina at the macula that was
    leaking fluid and mentioned a long medical term.
    The Dr. said the blurry vision should clear up in 7 days but
    there has been no improvement.
    I emailed the Dr. but have had no response.
    Why did he say it should clear up in 7 days ? I read from these
    other folks that they have had many injections.
    Thanks.

    • Randall V. Wong, M.D. December 31, 2010 at 11:15 am

      Dear Harold,

      Tough for me to read your doctor’s mind. If you could come up with the diagnosis, it would help me answer you more directly. You either have neovascularization from wet macular degeneration, or, macular edema from diabetes or a vascular occlusion.

      In my experience, neovascularization from ARMD responds faster to the injections though I’m not so sure as fast as 7 days.

      Happy New Year,

      Randy

  • Marty February 5, 2011 at 12:17 pm

    I was diagnosed with wmd in the left eye in January of this year. I received my first shot at 9am on January 6th. All went well until around 5:30 or 6:00 that night. Then I started to get severe pain in the eye I received the injection in. It was as if I had a piece of glass in my eye. The Doctor thought it could have bee because I went golfing that afternoon after the shot. He called in actaminophem-cod #3 and erythomyin ointment witch I used and covered the eye and slept all night. The next morning the eye was better and by Saturday the pain was gone.
    I received the next shot Feb. 3 around 9 am. Once again all went well until around 5:oo or 6:00 that night. The same thing started again. I had to use the cream and cover the eye. I had to take 2 pills and finally got to sleep around 8 or 9pm. Woke up the next morning and the eye was much better the pain was pretty much gone but I left the patch on until sat. morning.
    I know I need the shot but the pain I have that night is almost more than i can take. I am hoping the Doctor can do something for the pain. My father had these shots this summer with no problems and I know many more people who have no problems. I know I am a exception but for me if there is nothing that can be done for the severe pain I am having I am thinking of not getting anymore injections.

    • Randall V. Wong, M.D. February 7, 2011 at 3:54 pm

      Dear Marty,

      During the preparation for the injection, what is used to cleanse the eye, if anything?

      In my experience, very few patients of mine have similar problems and I’ve found that it is related to an iodine based solution that we use just prior to the injection.

      I am not saying this is exactly what is happening, but I’d investigate this possibility first.

      Randy

  • Marty February 7, 2011 at 6:11 pm

    Dr. Wong thank you for your quick reply.
    I am not sure what they use but I think the Dr. that was on call that night did say something about iodine. I was in so much pain that I am not sure but I will find out.
    I talked to one of the technicians in the Dr.s office today. She said that they have never had this problem. The Dr. is suppose to call me tomorrow. I will ask him about the iodine. I do not want to go threw that again. Two times is enough. Thank you again very much.

    Marty

  • Marty March 10, 2011 at 8:09 am

    Dr Wong you were right. After talking with the doctor he said it was more than likely the betadine. Instead of covering my eye with the betadine he put some on a qtip and put it just were he was going to give the injection. Then after the injection they washed the eye out 3 times and cover it till the next morning. NO pain at all and he say’s the eye is getting better.
    Thanks again
    Marty.

  • Eric March 10, 2011 at 9:31 pm

    Hi,

    I took Avastin injection 2 days ago on my right eye. And I did not notice any improvement on my eye. I did not see any web spider floating. Any input from you, Doc?

    My age is 30, diagnosed for myopic cnv. I had power minus 12 on both eyes. I wear glasses since kindergarten and the power develops over time. At age around 18-20 in year 2003 when the power seem stable at minus 12, I had LASIK to remove the power. LASIK went well now I had minus 1 on both eyes.

    • Randall V. Wong, M.D. March 15, 2011 at 11:28 am

      Dear Eric,

      In my experience, you may not notice a change for a few weeks.

      Hang in there!

      Randy

  • Eric March 17, 2011 at 1:15 am

    Hi Doc,

    I have news for eye technology. Briefly, injection on eye is not a liquid (Avastin/Lucentis) anymore instead of micro-robot. This robot will have duty to “clean” the frozen blood on the retina.

    Here is the link http://www.pcworld.com/article/222013/robots_swim_through_eyes_to_give_treatment.html

    This is still ongoing research at IRIS, Swiss. But soon will become reality.

    Regards

  • Shirley West March 19, 2011 at 12:38 am

    I had a stroke in the eyes due to high B pressure. Started with a profuse nose bleed, which drove my BP sky high 225/125.

    In the ER at the hospital to stop the nose bleed, gave me a powerful medication that dropped my BP down to 90/40 in just a few minutes, causing a TIA which temporily effected my speech center, and the stroke in my eyes. I had no clue of the stroke in my eyes. The only difference when I read, the page looked yellow in my left eye.

    I went to the Optometrist a month later to see why I had the yellow cast when I read. He told me I had had a stroke (inclusion) and that my eyes were bleeding. I did not have macula degeneration.

    He sent me to the Opthamalogist who gave me an injection of Avastin. From that time on I have had severe distortion in that eye and have refused any more injections of Avastin fearing I will lose total vision in that eye. After the injection, it felt like the needle was still in my eye for days. Before the injection I had no distortion or blurred vision in my eyes, only the page when I read had a yellow cast out of the left eye.

    This is the worst thing that has ever happened to me. I have been depressed ever since, it’s been seven months. I can’t read anymore, because the distorted eye overpowers my less affected eye. Hard to watch TV or use computer. I’m very fearful for my vision. I wish I had never taken the injection. I feel it destroyed my vision. Thanks for your website, but all I’ve read is good news, am I the only one who has reacted to the Avastin injection this way, I would appreciate your comment………….Shirley West

    • Randall V. Wong, M.D. March 20, 2011 at 7:42 pm

      Dear Ms. West,

      Tough to tell exactly what has happened. I would like to know if you had either a vein occlusion or an artery occlusion?

      The distortion may be due to significant macular swelling as a result of the “stroke.”

      It has been my experience that one not need to worry about Avastin causing distortion, but indeed, it may be due to the vascular occlusion,

      Randy

  • Ruthie March 25, 2011 at 11:31 am

    The beginning of this year I had a retinal occlusioin. Having an extensive history of eye problems I thought the scotoma in the upper portion of my R eye was the beginning of migraine aura. The problem was it didn’t go away and was only in one eye. Another problem, I was on my way to Florida from NJ for the winter and the seriousness of the situation really didn’t hit me as my central vision was fine. Two weeks after the event I saw an RS and then realized I was in some trouble. All tests were done and the diagnosis was BRVO non-ischemic…VA was 20/25…IOP in both eyes was 12…there was a small amount of macular edema…. a ‘wait and see approach was taken’. I do have health issues which have been addressed and under control.

    I returned to the office 6 weeks later and some changes had taken place. VA was 20/30 the OCT showed increased edema…IOP remained at 12. Due to my advanced glaucoma I take several eye drops and it is critical for me to keep the pressures down so I was happy. I have a retinal pucker/wrinkle in my L eye and never noticed it as this was not my dominant eye but now I do. The plan was an Avastin injection in 3 weeks.

    I had the injection 2 days ago. It went smoothly. I’ve had 5-FU injections in the past so knew what to expect. I was told to continue my glaucoma eye drops and the only problem with this whole thing is the Cosopt stings…wow…it’s easing up though….My question is does one injection ever resolve the edema? Does IOP’s rise dramatically after the Avastin injection? My RS said they can go up but come down quickly. I’ve read otherwise. How likely in my case can the brvo change from nonischemic to ishemic? It has been three months since the event.

    Thank you for your valuable time…….Ruthie

    • Randall V. Wong, M.D. March 29, 2011 at 2:31 pm

      Dear Ruthie,

      1. One injection may do the trick with regard to improving the retinal edema.
      2. IOP’s can rise due to volume changes from the injection, but they almost always resolve very quickly. I agree with your RS.
      3. Unlikely that your BRVO will become ischemic.

      It sounds as if you are doing quite well. You are lucky that not much of your vision was lost.

      All the best,

      Randy

  • Marty April 3, 2011 at 9:58 am

    Dr. Wong

    Just received my 4th avastin injection on 3/31. Everything went well and the eye seems to be getting a little better. Now I am leaving my winter home in Florida and heading back home. I have to find an RS there to give me my injections. Any chance of you moving to Kokomo Indiana? lol

    Marty

    • Randall V. Wong, M.D. April 7, 2011 at 7:47 am

      Marty,

      Best of luck.

      My kids just went up against a team from Indianapolis. Great hockey team. One of my kids now thinks we should move there…but probably not soon.

      Take care.

      Randy

  • Ruthie April 6, 2011 at 4:39 pm

    Thank you Dr Wong for your reassurance.

    I went back for my one week post avastin injection check-up this week. Comparing the before and after OCT’s of the macular edema was interesting. The little mountain of fluid was now flat. I was surprised this happened so quickly. My RS was delighted and so was I. Of course I realize the edema may return but who knows maybe I’ll be one of the lucky few who only need one injection.

    Marty….. I am leaving Florida soon myself and returning to NJ. Make sure you gather up all your information from your RS to bring home. They gave me all my scans as well. Good luck finding a new retina specialist.

    Ruthie

    • Randall V. Wong, M.D. April 7, 2011 at 7:55 am

      Dear Ruthie,

      Congrats! I’m surprised, too, at the quick resolution.

      Safe travels.

      r

  • Stacey April 25, 2011 at 7:07 pm

    Dear Dr. Wong,

    Since having Avastin shots beginning last Oct. for Nevus looking more like Cancer I have been experiencing hair loss. Going to Bascom Palmer in Miami Florida. I have a great doctor, Dr. Murray. He’s been keeping an eye on for three years but last oct started to have fluid on the eye. ever since the first Avastin shot I have been experiencing hair loss….lots. I’m 39 and not near menopause and eat well. what do you think? Is there a possibility? Thanks for your time.

    Please Help!
    Stacey

    • Randall V. Wong, M.D. April 27, 2011 at 7:53 am

      Dear Stacey,

      What an ordeal you are experiencing! I would defer to Dr. Murray for your questions as I am not sure I’ve had any patients experiencing these symptoms of hair loss.

      Randy

  • Jose, May 13, 2011 at 12:15 pm

    Dear Dr. Wong,
    My wife was given Avastin for VKH. Is this a common treatment method for this syndrome?

    • Randall V. Wong, M.D. May 16, 2011 at 5:45 pm

      Dear Jose,

      No, not a common treatment, but I think it is a reasonable thing to consider if she has macular edema and is losing vision. Steroids are commonly used, too.

      Randy

  • Dan Roberts May 14, 2011 at 11:05 am

    Dr. Wong,

    Thank you for providing this information. Several other patient perspectives on these and other eye treatments are published in ongoing accounts at http://www.mdsupport.org/archives.html . I hope this will help add to your readers’ knowledge.

  • Ruthie July 6, 2011 at 8:09 pm

    Hello Dr Wong,

    I was hoping I was one of the few who would only need one Avastin injection but that was not to be. Upon returning home to NJ my vision began to change and I knew the macular edema was returning. It took about 2 months for this to present itself. After several tests the plan was to have five more injections one every five weeks.

    This second injection, the first one being done in Florida, was very difficult. The preparation and the injection were fine but the aftermath was almost unbearable. I have glaucoma and take Cosopt 2x’s daily and Lumigan in the evening. I was told to continue all my drops including the antibiotic . Every drop burned but the Cosopt literally made my knees buckle. Because the burning, stinging, was so bad the eye felt irritated longer and it took several days to recuperate from the injection. As the injection was on a Friday I spoke to the office the following Monday and they said the doctor would discuss it with me on my next visit as the discomfort by this time was starting to subside,. I now have 10 days to go before the next injection and already am becoming nervous. Any suggestions?

    Thanks ,
    Ruthie

    • Randall V. Wong, M.D. July 11, 2011 at 9:46 am

      Dear Ruthie,

      It sounds as if you might be one of the few who might be terribly sensitive to Betadine, the preparation used to cleanse the eye prior to injection. I have several patients who are terribly uncomfortable for the entire day following an injection.

      Ask your doc.

      Randy

  • Cassie July 13, 2011 at 4:45 pm

    Dear Dr. Wong,
    I had a severe eye injury a few months ago and was referred to a retina specialist. He told me that I have blood vessels forming close to the macula and that I needed the avastin shots to help clear them up. On Friday I had my first injection. I really didn’t have any problems until two day later. At that point my vision became blurry, the white part of my eye looks as though it has a bubble of fluid underneath it. My eye is also blood shot on both sides of my eye. I am also having a lot of burning and itching. I called my doctor twice this week to see what they suggested. Both times they seemed to think that it was just a reaction to the medicaiton they used to prep the eye before the injection and not from the avastin. They told me to keep using the artificial tears. Does this sound normal or should I be concerned? I don’t know what they used to numb my eye with etc.

    • Randall V. Wong, M.D. July 18, 2011 at 2:19 pm

      Dear Cassie,

      Sorry for the delay. It’s tough to say exactly what’s going on with you. I’m sure it has been resolved by now (since I took a few days in responding). You did the right thing by calling your doc and alerting them.

      Randy

  • Marty August 21, 2011 at 3:41 pm

    Hello Dr. Wong
    After getting back to Indiana I have received 2 more injections witch make 6 all together. The eye doctor here took scans of the eye and said the macular was clear after the 4th injection and sees no reason to keep giving me injections. Even though the macular is clear I did not get any vision back. The vision in my left eye is about 20/100. I go back in 5 weeks to check for bleeding again but he said that he does not think I will gain any vision back.
    Marty

    • Randall V. Wong, M.D. August 22, 2011 at 11:30 am

      Dear Marty,

      Present recommendations are to examine patients regularly then re-treat or re-inject as needed. Sounds like you are in good hands.

      r

  • Collin August 26, 2011 at 2:46 am

    Dear Dr. Wong,
    I was diagnosed at 10 yrs old with Best Disease. My right eye is well into stage 4 if not 5 and my left eye has recently started to scramble. My doctor is recommending Avastin shots to help treat this. He wants to start with injections in my right eye first. I have found little information on the internet that pertains to Avastin working for Best patients. What I have found is that Avastin removes fluid, but does not significantly change the vision in Best patients. Do you have any insight on this?
    Thank you in advance, I appreciate your time.
    Collin

    • Randall V. Wong, M.D. August 29, 2011 at 11:05 am

      Dear Collin,

      There must be some leakage or change in your vision? I am afraid I can’t offer much insight to this as I don’t have enough information from you.

      Randy

  • JOE FARRUGIA September 21, 2012 at 8:49 pm

    A question please……if I may.

    I was diagnosed with AMD wet type in my right eye in November 1911. I read that a doctor in Florida just some 6 years ago or so used Avastin injections to treat his patients for Macular Degeneration. Not sure of the Dr.’s name but I think the name was Rosenfield.
    This treatment cost the patients just $18 NOT $1,800 which Lucentis injections cost. The doctor treated 73 patients only giving 3 injections resulting in a total cure. If I can find a doctor involved in this treatment I would be willing to seek his help. I am 79 and am a fairly active person. I am hoping someone who reads this message could help me with locating a doctor who would treat AMD. I live in Norwalk, Connecticut and due to my age I am a little restricted in my movements…traveling away from home. Will you kindly…anyone who is inclined to want to help me in this matter, please email me as shown above that is: joefarrugia33@aol.com Thanking you all in anticipation. Joe

    • Randall V. Wong, M.D. September 25, 2012 at 9:40 pm

      Dear Joe,

      1. Rosenfeld
      2. Avastin is about $35-$50.
      3. Total cure is not really possible, but it’s what we’d all shoot for.
      4. There should be a retina doc near you who routinely uses Avastin for wet ARMD. By the way, do actually have wet ARMD?

      Stay in touch.

      r

  • Kathy March 12, 2013 at 9:18 pm

    Dear Dr. Wong,

    I have had had myopic macular degeneration for twenty years. Between 1992 and 2000, I had 5 retinal hemorrhages, affecting both eyes, which were successfully treated with laser. I was symptom free for 12 years then, a couple of months ago, I had another bleed. This time I was given an Avastin shot. The bleeding cleared, but I have been left with some significant ‘blind spots’, which my surgeon attributes to retinal atrophy, not the Avastin shot itself.

    As I have had this disease for many years, I understand that retinal atrophy may have been present for a while, but I’ve never noticed its effects until now. I find it too much of a coincidence that I had the Avastin, then two weeks later noticed the ‘blind spots,’ which have worsened my vision considerably. It is possible that the Avastin has triggered this situation? I need to know because there is a possibility that I might need more shots in the future.

    Thanks in advance for your insights.

  • Kathy March 20, 2013 at 9:06 pm

    Dear Dr. Wong,

    I have had myopic macular degeneration for twenty years. Between 1992 and 2000, I had 5 retinal hemorrhages, affecting both eyes, which were successfully treated with laser. I was symptom free for 12 years then, three months ago, I had another bleed. This time I was given an Avastin shot. The bleeding cleared, but I have been left with some significant ‘blind spots’, which my surgeon attributes to retinal atrophy, not the Avastin shot itself.

    As I have had this disease for many years, I understand that retinal atrophy may have been present for a while, but I’ve never noticed its effects until now. I find it too much of a coincidence that I had the Avastin, then two weeks later noticed the first blind spots, which appear to be progressing and have worsened my vision considerably. It is possible that the Avastin has triggered this situation? I need to know because there is a possibility that I might need more shots in the future.

    Thanks in advance for your insights.

  • Sheila April 6, 2013 at 8:53 pm

    Dr Wong,

    I am 36 years old , high myopia -14 D in both eyes.

    I started seeing distortion with my right eye , been 3 weeks , my last visit to my RS was 3/27 . I got AVASTin shot in left eye as there was fluid leak. They did OCT scan for both eyes. Last 2 visits 3/14/14 and 3/27/14 I mentioned to my RS about the waviness i noticed in my right eye , which I didn’t had at all until 3/14. He says he cannot treat me right now. its not going to help me as OCT scan shows normal.

    I was checking with Amsler grid everyday since feb2013. My right was perfect no waviness at all until 3/14.

    Do you think the machine missed to capture the leak in my right eye?

    If my RS waits until it shows on OCT scan and then treat my right eye will the waviness go away with the shot?

    will it harm to get a shot in right eye as already seeing wavy?

    With my left eye I already see wavy , because i have scars from previously untreated abnormal blood vessel growth.

    I just to be safe and save my right eye.

    Any help is appreciated. Thankyou
    Please

    • Randall V. Wong, M.D. April 23, 2013 at 8:58 am

      Dear Sheila,

      Can’t really tell. Many things can cause distortion. A fluorescein angiogram, however, might be very helpful in this instance. Ask your RS about this.

      Randy

  • Betty October 4, 2013 at 11:35 pm

    Had avastin shot . The third one hit a vein blood in my eye. Got shot wed. Still looks same. TODAY Friday. Retina Dr. said like a bruise they hit vein I have also had two laser and cataracet surgery implant. in this eye(right eye. Two laser and two shots in left eye. First time this happen They want to do laser in two weeks .For some reason they wanted to do laser and shot at same time . Different person doing procedures. I told them I did not want both at same time.I think that was a good choice after what happen with shot.How long should This blood last in my eye. Now is it safe to have laser and more shots since they bruised my eye. Does this happen very often hiting vein .I have diabeties Ret., swelling edma . I am 65 yr old woman. My eyes are worst.

  • Betty October 8, 2013 at 9:39 am

    Yes I am Diabetic. Have edema bad in right eye. Two laser in each eye. They say laser for bleeding. Last time new person at center said more popped up. I was told by a friend their retina Dr. does not do laser for this reason. More pop up. I wonder if I made a mistake by letting them do this laser.. Now the Avastin shot has bruised my eye. Looks like blood in eye covers white eye on side gave shot. It has been six days eye still blood red. I don’t know how long this should last. II went back day after shot they said they hit vein. Brused my eye. I was suppose to go back in two weeks for laser treatment. This will be third laser in this eye was my third shot. My optomaligst did cataract surgery on this eye last year ( turned out great could see so much better). IMy opt. Dr. sent me to retina dr. to get shot so he could do surgery because could not see behind eye I quess worried about bleeding. So the Retinq ctr. has continued to do procedures .I thought I wqs going for only one shot. This seems to be on going. They say if don’t do these things could lose sight. I am afraid if keep doing mayy lose sight. what advise would you give on continuing these laser treatments. If I stop both now will make worst. I have been reading lot good results people writing in to you. I do have diabeties can’t get my sugars normal average 300’s. They were much higher. . Take 4 shots a day. Having lot health problems.. I don’t know what to do about about eyes. . Should I not be so afraid of these procedures. Will hurt to have this laser with bruised blood eye. Is it true more blood spots pop up when you haver laser as I was told by friend some doctors don’t do this because more blood spots pop up.

  • Kathy November 16, 2013 at 2:26 pm

    I am new to this process and frankly a little scared. I had cataract surgery last May. Prior to that had no eye issues other than poor eyesight. Following cataract surgery, my vision was amazing and I functioned well with reading glasses. My first sign of trouble was the arrival of floaters in my left eye. Retina specialist told me I had a bleed and did a laser treatment. A few weeks later, my right eye filled with floaters, almost to the point that I couldn’t see. At first, the RS said it was just floaters and nothing could be done. 6 weeks later, he said it too was a bleed and did a laser treatment. The right eye is much better but now the left eye has lost vision clarity and the RS says I have Macular Edema and need an injection. This progression has taken 6 months. I’m frightened of the injection, or I should say, the fact that I am reading that most people end up with 8 or more injections. I am also seeing that the injections have not been successful much of the time. I am Diabetic but I control it well with oral meds and diet. I am concerned that the disease is going to take my vision whether I go through this process or not. What are the statistics about the number of people thie injections actually help?

  • Kristin November 17, 2013 at 4:13 pm

    I was just diagnosed with POHS. I was administered an Avastin injection in my left eye due to a macular edema that was causing slight distortion in the upper right quadrant. It has only been a few days since my injection, so I have not noticed any visable changes yet.
    In your opinion, is it better to use Avastin or Lucentis in treating POHS?
    I am concerned with the reports of infection from using Avastin. Should I be concerned?
    Are there any lifestyle changes that I can make, or supplements that I can take, to help prevent future problems caused by POHS?
    Is it good to get a second opinion on my diagnosis?

    • Randall V. Wong, M.D. November 26, 2013 at 7:12 am

      Kristin,

      Second opinions are valuable, but don’t waste too much time. Visual results with POHS, when involving the macula, depend upon the timeliness of treatment. Avastin and Lucentis, in my opinion, usually have the same results.

      Infection from Avastin has been linked to the preparation of the Avastin in compounding pharmacies. Compounding pharmacies must break up the Avastin for use whereas Lucentis is packaged by the manufacturer.

      The drug itself is good.

      Randy
      Randall V. Wong, M.D.
      Retina Specialist
      Fairfax, VA 22030

      http://www.TotalRetina.com

  • bobbie August 19, 2014 at 8:30 pm

    does avastin help fluid caused by angio streaks resulting from PXE ? vision already impaired.

    • Randall V. Wong, M.D. August 25, 2014 at 12:29 pm

      bobbie,

      Avastin may indeed help if there is neovascularization associated with the angioid streaks.

      Randy

  • Saranya June 29, 2018 at 12:55 pm

    Hello from India Dr. Randall Wong. I really hope you’d read this message. My 79 year old father is a diabetic since last 8 years & has ARMD in both eyes with advanced sub retinal hemorrhage in the bad eye and early scarring in the other. The dr here administers Avastin only once in 10 or 11 days. Dad had his first shot in his bad eye today after 12 days of showing the first signs of ARMD( blurring, black spot,jumping images). The next injection after review is only after 11 days. My question is won’t the eye that hasn’t received any treatment lose more vision if we waited that long? What can I do? Thank you so much for this article Dr. Hope you can help me.

    • Randall Wong, M.D. September 23, 2018 at 10:52 am

      Sorry for delay.

      I usually don’t inject any more frequently than every 4 weeks. Good luck.

      Randy

  • Karen Kuhn January 2, 2019 at 3:50 am

    My 14 year old daughter has developed a new blood vessel in her right eye and it is bleeding, causing obvious vision problems. She was given a shot of Avastin yesterday. She is incredibly healthy, no medications, very active, no diabetes and no family history of macular degeneration. This is definately not a typical story. I feel like I need a reason why this happened so we do not miss something else that might be going on. Any suggestions?

    • Randall Wong, M.D. August 20, 2019 at 7:06 pm

      There are retinal conditions which develop neovascularization in young kids – no real cause that we know. Would recommend asking your doc – which I’m sure you have considering this very long response time. I hope your daughter is well.

      r

  • Carol November 9, 2019 at 1:09 pm

    How long does it take after injection for my vision to clear. It’s been 3 day and still blurry. I have retinal occlusion in my left eye.

    • Randall Wong, M.D. December 16, 2019 at 9:14 pm

      Carol,

      Depending upon the type of occlusion, the severity of the occlusion, your age and severity of vision loss…rehabilitation may take months – if at all. Randy

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