01 Aug Safety of Intraocular Injections | Infection
This is series of articles co-authored by John Sullivan, M.D., a retina specialist in Jacksonville, Florida. John and I trained together.
This is Part 2.
Part 1 – Intraocular Injections
Possible complications of intraocular injections (IVT) include cataract formation, increased eye pressure, inflammation, retinal detachment and endophthalmitis (blinding intraocular infection).
Of those listed, the most feared is infection inside the eye. Infection inside the eye can cause blindness.
What is the Chance of Infection?
The chance of developing endophthalmitis after intraocular injection is somewhere around 1:2000. No one knows the true chances. This approximates the chances of infection from cataract surgery.
Why? Because endophthalmitis does not occur very often. Complications which are uncommon are difficult to measure. Studying endophthalmitis has always been difficult due to the fact it occurs so infrequently.
There are several factors influencing the chances of getting an infection; size of needle, volume of medication to be injected, the actual medication injected, etc.
Source of Infection
No one really knows the source of the bacteria which cause the infection. The presumed source is from the patient’s own tears, conjunctiva and eyelids. There is some strong evidence supporting this theory.
Other possible sources include spreading of infection from respiratory sources (i.e. droplets of saliva/secretions from speaking/sneezing).
Preventing Infection from IVT
Betadine is the best accepted antiseptic for cleaning the eye prior to IVT (injection). It is used by most retina specialists just before the intraocular injection is given.
Betadine works rapidly and a few drops are often placed on the eye prior to IVT.
Topical antibiotic drops may also be recommended by many retina specialists starting a few days before the injection and continued shortly after the injection.
Many retina specialists will use gloves, masks or a lid speculum to aid in the prevention of infection.