The idea of an eye injection, often called an intravitreal injection, naturally causes anxiety for many people. Due to highly effective numbing techniques, however, the procedure is typically not described as painful by patients. Instead of sharp pain, most people report feeling a sensation of pressure or mild discomfort during the brief moment of the injection.
The injection delivers sight-saving medication directly into the vitreous cavity, the gel-filled space at the back of the eye. This treatment is used for conditions like macular degeneration or diabetic retinopathy. Modern medical protocols are designed to maximize patient comfort and minimize sensation during the procedure.
Anesthesia and Pain Prevention Methods
The primary strategy for pain prevention relies on topical anesthetics, which are administered to the eye’s surface before the procedure begins. These anesthetics typically come as drops or a lubricating gel, such as lidocaine or tetracaine, and work by temporarily blocking nerve signals in the outer layers of the eye. The goal is to achieve complete surface numbness so that the needle’s entry through the sclera, the white part of the eye, is not felt.
Multiple doses of these drops are often applied in the minutes leading up to the injection to ensure the numbing effect is profound and lasts through the short duration of the treatment. In some cases, a clinician may also use a small cotton pledget soaked in a concentrated anesthetic solution and press it briefly against the injection site for a deeper local numbing effect. This preparation ensures the eye is desensitized, preventing the transmission of pain signals during the actual injection.
What the Patient Actually Feels
While the anesthetic prevents pain, it does not eliminate all sensation, so patients should be prepared for distinct feelings during the procedure. The most commonly reported sensation is pressure, caused by the eyelid speculum—an instrument used to gently hold the eyelids open—and the slight manipulation of the eye by the physician. This pressure is usually described as a push rather than a painful sensation.
Another noticeable feeling is the application of the antiseptic solution, usually povidone-iodine, which is painted onto the eye to sterilize the surface and prevent infection. This application may cause a temporary, mild burning or cold feeling. The actual injection is extremely fast, often lasting only a few seconds, as a very thin needle is used. Some patients also report seeing a swirl of liquid or a shadow as the medication is introduced.
Managing Post-Procedure Discomfort
Once the anesthesia wears off, typically within 30 minutes to an hour, it is common to experience mild, temporary discomfort. This often manifests as a scratchy, gritty, or foreign body sensation, usually a reaction to the antiseptic solution or minor surface irritation from the speculum. The surface of the eye may also appear red in one spot due to a small subconjunctival hemorrhage where the needle entered, which is similar to a tiny, painless bruise.
This mild irritation can often be managed using preservative-free artificial tears or lubricating drops as recommended by the doctor. It is important to avoid rubbing the eye, as the surface is temporarily vulnerable while healing. Over-the-counter pain relievers, such as acetaminophen, can be used for mild soreness. Patients must contact their eye specialist immediately if they experience severe, constant pain, a significant decrease in vision, new onset of severe floaters, or increased swelling or discharge, as these can be signs of a rare complication.