Intravitreal Injection
What is an Intravitreal Injection?
An intravitreal injection is a procedure where medication is injected directly into the vitreous cavity of the eye (the gel-like space behind the lens) to treat retinal conditions affecting the back of the eye. It delivers drugs like anti-VEGF agents or steroids to manage diseases that can lead to vision loss. In India, intravitreal injections are performed in ophthalmology departments at hospitals like Apollo, Fortis, Medanta, and AIIMS, often at affordable costs. Understanding the procedure, costs, recovery, risks, and frequently asked questions (FAQs) is essential for patients in India to make informed decisions.
Why do you need Intravitreal Injection?
Intravitreal injections are indicated for:
- Retinal conditions:
- Wet age-related macular degeneration (AMD): Abnormal blood vessel growth (neovascularization) under the retina; treated with anti-VEGF drugs (e.g., ranibizumab, aflibercept).
- Diabetic macular edema (DME): Swelling in the macula due to diabetes; treated with anti-VEGF or steroids (e.g., dexamethasone implant).
- Retinal vein occlusion (RVO): Blockage causing macular edema; treated with anti-VEGF or steroids.
- Macular edema from uveitis: Inflammation-related swelling; treated with steroids.
- Other conditions:
- Vitreous hemorrhage: If associated with neovascularization (e.g., diabetic retinopathy); anti-VEGF helps.
- Endophthalmitis (rare): Antibiotics (e.g., vancomycin, ceftazidime) injected for severe infections.
- Goal:
- Reduce swelling, stop abnormal vessel growth, or treat infection to preserve or improve vision.
The procedure delivers high drug concentrations directly to the retina, bypassing systemic circulation, with effects lasting 4–12 weeks depending on the medication.
Why Do Intravitreal Injection Costs Vary in India?
Costs range from ₹10,000 to ₹50,000 per injection:
- Medication Type: Bevacizumab (off-label, ₹10,000–₹15,000); ranibizumab/aflibercept (₹20,000–₹40,000); dexamethasone implant (₹30,000–₹50,000).
- Hospital/Location: Higher in metro cities (Apollo, Fortis); lower in government hospitals (AIIMS, ₹5,000–₹15,000; often subsidized under schemes like Ayushman Bharat).
- Surgeon’s Expertise: Experienced retina specialists charge more.
- Additional Costs: Pre-injection tests (e.g., OCT, ₹2,000–₹5,000), injection fee (₹2,000–₹5,000), post-injection medications (₹500–₹1,000).
- Insurance: Covered for medical necessity (e.g., wet AMD, DME); confirm with your provider.
Intravitreal Injection Procedure
- Before Injection Evaluation:
- Diagnosis:
- Optical coherence tomography (OCT): Assesses macular edema or neovascularization.
- Fluorescein angiography: Maps retinal blood flow (e.g., for wet AMD, RVO).
- Visual acuity test: Measures vision impairment.
- Slit-lamp exam: Checks for infection or inflammation.
- Blood tests: Blood sugar (for diabetics), infection screening if systemic issues suspected.
- Medications: Continue regular eye drops; blood thinners usually not stopped (low bleeding risk).
- Consent: Risks, including infection, are explained.
- Diagnosis:
- Injection Techniques:
- Intravitreal Injection:
- Performed in a sterile clinic or OT, lasting 5–10 minutes.
- Local anesthesia: Topical drops (e.g., proparacaine) or subconjunctival injection to numb the eye.
- The eye is cleaned with povidone-iodine (5%) to reduce infection risk.
- A speculum holds the eyelids open.
- The injection site is marked 3–4 mm from the limbus (cornea-sclera junction) in the sclera (usually inferotemporal quadrant).
- A fine needle (30-gauge) injects the medication (e.g., 0.05 mL of ranibizumab) into the vitreous cavity.
- The needle is removed; the site may be gently pressed to prevent leakage.
- Antibiotic drops (e.g., moxifloxacin) are applied post-injection.
- Common Medications:
- Anti-VEGF: Ranibizumab (Lucentis), aflibercept (Eylea), bevacizumab (Avastin, off-label).
- Steroids: Dexamethasone implant (Ozurdex), triamcinolone acetonide.
- Antibiotics: For infection (e.g., vancomycin for endophthalmitis).
- Intraoperative Tools:
- 30-gauge needle: Delivers medication.
- Speculum: Keeps eyelids open.
- Caliper: Marks injection site.
- Intravitreal Injection:
- After Injection:
- Observation: 15–30 minutes to check for immediate complications (e.g., IOP spike).
- Eye care: Antibiotic drops for 3–5 days (optional, varies by protocol).
- Instructions: Avoid rubbing the eye or water exposure for 1–2 days.
- Frequency: Often repeated (e.g., monthly for anti-VEGF in wet AMD, 3–6 months for dexamethasone implant).
Recovery After Intravitreal Injection
- Immediate Recovery: Observation for 15–30 minutes; same-day return to normal activities.
- Post-Injection Care:
- Vision: May be blurry for a few hours due to dilation or floaters (air bubble/drug); improves within 1–2 days.
- Discomfort: Mild irritation, redness, or foreign body sensation for 1–2 days; managed with artificial tears.
- Eye care: Antibiotic drops (if prescribed) for 3–5 days; avoid rubbing the eye or water exposure for 1–2 days.
- Activity: No restrictions; avoid strenuous activity for 1 day if discomfort persists.
- Effect: Anti-VEGF effects start in 1–2 weeks, lasting 4–8 weeks; steroids (e.g., Ozurdex) last 3–6 months.
- Follow-Up:
- Visit at 1–4 weeks to monitor response (e.g., OCT for macular edema).
- Repeat injections: Monthly (anti-VEGF) or as needed (steroids), based on disease activity.
Most resume normal activities immediately; minor discomfort resolves in 1–2 days. Success rate: 70–90% show reduced edema or stabilized vision (e.g., wet AMD, DME) after a series of injections.
Risks and Complications
- Injection-Related Risks:
- Endophthalmitis (<0.05%): Rare but serious infection; causes pain, redness, vision loss; needs urgent antibiotics or vitrectomy.
- Retinal detachment (<0.1%): Needle trauma; causes flashes, floaters, vision loss; needs urgent surgery.
- Vitreous hemorrhage (<0.1%): Bleeding into the vitreous; usually resolves, may need vitrectomy if persistent.
- Post-Injection:
- Raised intraocular pressure (1–3%): Temporary spike, esp. with steroids; managed with drops.
- Floaters (5–10%): Air bubble or drug particles; resolve in 1–2 days.
- Subconjunctival hemorrhage (5–10%): Red spot at injection site; resolves in 1–2 weeks.
- Lens damage (<0.1%): Needle may nick the lens, causing cataract; rare, may need cataract surgery.
- Long-Term (Steroids):
- Cataract (10–30% with repeated steroid injections): Lens clouding; may need surgery.
- Glaucoma (5–15% with steroids): Elevated IOP; managed with drops or surgery.
Report severe pain, sudden vision loss, flashes/floaters, or redness promptly.
Frequently Asked Questions (FAQs)
What conditions require intravitreal injections?
Wet AMD, diabetic macular edema, retinal vein occlusion, uveitic macular edema, or severe infections (e.g., endophthalmitis).
Can I avoid intravitreal injections?
Sometimes; early-stage wet AMD or DME may respond to laser or systemic control (e.g., diabetes management), but injections are often the most effective for advanced cases.
Is the injection painful?
No, performed with anesthesia; mild discomfort during injection, resolves quickly.
How soon can I resume activities?
Normal activities immediately; avoid rubbing the eye or water exposure for 1–2 days.
Is intravitreal injection covered by insurance in India?
Yes, for medical necessity (e.g., wet AMD, DME); confirm with your provider.
Signs of complications?
Severe pain, sudden vision loss, flashes/floaters, or increased redness.
How often will I need injections?
Anti-VEGF: Monthly for 3–6 doses, then as needed; steroids: Every 3–6 months, depending on the drug.
Lifestyle changes post-injection?
Avoid rubbing the eye for 1–2 days, use prescribed drops, attend follow-ups, and monitor for vision changes.
Conclusion
Intravitreal injections are a highly effective treatment for retinal conditions, preserving or improving vision with minimal downtime. India’s top hospitals (Apollo, Fortis, AIIMS) provide affordable, expert care, often covered by insurance. Understanding the procedure, costs, recovery, risks, and FAQs helps patients approach treatment confidently. Consult a retina specialist for personalized guidance and optimal outcomes.
Looking for Best Hospitals for Intravitreal Injection
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we are not promoting any hospitals we sourced all the details from google and hospitals website, please verify and start with your surgery here we go the list includes government, budget and superspeciality hospitals accreditation bodies are the National Accreditation Board for Hospitals and Healthcare Providers (NABH) and the Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₹) | Maximum Price (₹) |
|---|---|---|
Agra |
10,000 |
45,000 |
Ahmedabad |
15,000 |
50,000 |
Ajmer |
10,000 |
45,000 |
Aligarh |
10,000 |
45,000 |
Allahabad |
10,000 |
45,000 |
Amritsar |
12,000 |
47,000 |
Aurangabad |
12,000 |
47,000 |
Bangalore |
15,000 |
50,000 |
Bareilly |
10,000 |
45,000 |
Belgaum |
12,000 |
47,000 |
Bhopal |
12,000 |
47,000 |
Bhubaneswar |
12,000 |
47,000 |
Bikaner |
10,000 |
45,000 |
Chandigarh |
15,000 |
50,000 |
Chennai |
15,000 |
50,000 |
Coimbatore |
15,000 |
50,000 |
Dehradun |
12,000 |
47,000 |
Delhi |
15,000 |
50,000 |
Dhanbad |
10,000 |
45,000 |
Durgapur |
10,000 |
45,000 |
Faridabad |
15,000 |
50,000 |
Ghaziabad |
15,000 |
50,000 |
Gorakhpur |
10,000 |
45,000 |
Guntur |
12,000 |
47,000 |
Gurgaon |
15,000 |
50,000 |
Guwahati |
12,000 |
47,000 |
Gwalior |
10,000 |
45,000 |
Hyderabad |
15,000 |
50,000 |
Indore |
12,000 |
47,000 |
Jabalpur |
10,000 |
45,000 |
Jaipur |
15,000 |
50,000 |
Jalandhar |
12,000 |
47,000 |
Jamshedpur |
12,000 |
47,000 |
Jodhpur |
10,000 |
45,000 |
Kanpur |
10,000 |
45,000 |
Kochi |
15,000 |
50,000 |
Kolkata |
15,000 |
50,000 |
Kollam |
12,000 |
47,000 |
Lucknow |
12,000 |
47,000 |
Ludhiana |
15,000 |
50,000 |
Madurai |
12,000 |
47,000 |
Mangalore |
12,000 |
47,000 |
Meerut |
10,000 |
45,000 |
Moradabad |
10,000 |
45,000 |
Mumbai |
15,000 |
50,000 |
Mysore |
15,000 |
50,000 |
Nagpur |
12,000 |
47,000 |
Nashik |
12,000 |
47,000 |
Navi Mumbai |
15,000 |
50,000 |
Noida |
15,000 |
50,000 |
Patna |
10,000 |
45,000 |
Pune |
15,000 |
50,000 |
Raipur |
12,000 |
47,000 |
Rajkot |
12,000 |
47,000 |
Ranchi |
10,000 |
45,000 |
Surat |
15,000 |
50,000 |
Thane |
15,000 |
50,000 |
Vadodara |
12,000 |
47,000 |
Varanasi |
10,000 |
45,000 |
Visakhapatnam |
12,000 |
47,000 |
Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.