1st Ozurdex - expectations : Hi all, I had... - Macular Society

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1st Ozurdex - expectations

charlie_mk profile image
12 Replies

Hi all,

I had my 1st Ozurdex inplant 2 days ago and it was terrible. Should it have hurt?! Everyone at the hospital said it'd take 3 seconds and not hurt AT ALL. I should only have felt a bit of "pushing".

I'm pretty sure the numbing drops didn't work. I've had them before so I know what they feel like. I did not feel numbed at all! It really was a horrendous experience and I never want to have it again :(

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charlie_mk
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12 Replies
Bunny1756 profile image
Bunny1756

Hi,

I am not the expert here. I am sure many others will help you further. Is this a medication implant? I would definitely go back to the doctor who did this to check you very carefully.

Warm wishes,

Bunny1756

charlie_mk profile image
charlie_mk in reply to Bunny1756

Thanks Bunny1756

Yes, it is a steroid implant so gives a slow release. In my case, it is to remedy an ongoing macular oedema. Thank you, I will be contacting the referring doctor this week to query what went wrong! x

Hi charlie, I am so sorry to hear this. My 7 ozurdex have all been better than all the 25 anti vegf inj I had before. (& they weren't all bad).

It most definitely should not have hurt.

You should write and complain.

In UK we get numbing drops then an anaesthetic inj (very fine needle, never felt it) before the actual implant ( never had anaesthetic inj before antivegf though I've read here some do, always with implant though and it should make it painless). Did you get this inj?

I did have one time they forgot to put it on tray and both Dr and I asked for it!

Most I've felt has been a bit of a push.

There was a weird sensation once when Dr massaged eyeball after - implant makes a tiny ' furrow' as it goes in which closes up but if slow to the Dr massages it closed. Only had that once. Didn't hurt.

Was your pain sharp or dull intense pressure? The first is lack of numbing, the second poor technique by inj. ( I had this my first antivegf inj too much pressure applied to clamp - thought I could never go through it again! But fear of sight loss won and never had one as bad - I did complain formally though!).

The blood spot you have can happen with any inj or implant ( they can't see vessels so do hit them sometimes - check out the pic on my old post lol) Not dangerous but can be uncomfortable/ painful for a while after. Buy some sterile soothing drops and use regularly. Should help a bit. Paracetamol too.

I hope you get sight improvement from your implant. Best wishes going forwards.

kateanne profile image
kateanne

Hi. How awful for you 😪 Because my last few injections caused corneal abrasions and also didn't work any more, I was told to have an ozurdex implant. I think he detected my anxiety and told me, in my case. I should have sedation. If you have to have another one, insist on having sedation. So glad to have had that. I was aware of things going on around me but didn't feel a thing. I sailed through it. It was only the intense pain and blurred vision I suffered for the following hours that was miserable. That was done just over a week ago and I still have a black blob floating around. Do hope you improve soon but remember, always ask for sedation. Hope you heal soon 😊

kateanne profile image
kateanne

Just to add to my previous comment. As eyesright said, you shouldn't normally feel anything. Sedation isn't offered routinely. It was in my case because of previous experience with injs. and anxiety. As you had a bad experience it may be worth suggesting if you had to have this again.

charlie_mk profile image
charlie_mk

Thank you kateanne and Hidden for your replies - both so helpful and knowledgeable!

It was all done at Moorfields in London, so I had confidence that I was getting excellent care.

On arrival, I did ask for sedation but was told that it would be painless and only take 3 seconds.

I didn't have any anaesthetic injection following the drops - this wasn't discussed as an option.

Initially it was just a lot of discomfort and pushing like she was struggling to break through and distorting my vision. Then came the intense sharp pain. I flinched a tiny amount and she backed up - sighing and obviously frustrated at me.

I found myself apologising but they were so cold towards me.

How I endured another 2 attempts I do not know - the 3rd being successful despite still agonising.

Maybe the fact that we had left home 7 hours ago and sat in a waiting room for 5 hours for this was what made me endure it. I have M.E so this day was particularly tough. My poor partner still had a 2 hour drive to do in rush hour yet.

I genuinely feel that they may have picked up the wrong drops...as I said in my OP, I've had numbing before and know what it feels like.

If I ever do have this again, I'm going to have to be heavily sedated or knocked out. I'm more fearful than ever now of anyone coming near my eyes.

Yes kateanne, I have my black blob! Mine is like a coach windscreen wiper from above LOL (at least I know it's in there then)

I have 5 days of antibiotic drops (4x day) which are quite soothing actually!

Thanks again both, I hope I've responded to all your points. I really appreciate you taking the time to advise me on this x

in reply to charlie_mk

Hi Charlie, your experience prompted me to read up about what drs are told to do re anaesthesia for ozurdex implant. I had naively thought the anaesthetic inj was standard protocol as the needle is bigger than the antivegf ones and the entry is more complicated ( angled rather than in/out).

Well......seems guidance is just to give " adequate anaesthetic to prevent pain".

From a couple of US/Canadian studies roughly speaking there are 4 methods and each seems to be used by a 1/4 of drs. I guess their personal preference?

Study reported no difference in pain other than with just the basic anaesthetic drops which had a higher incidence. Not surprisingly!!!

Personally though I can't imagine having it without the anaesthetic inj.

What was interesting is a statistically significant result showing those pseudophakic (ie with replacement lens) experience more pain regardless of anaesthetic method( though the study stated this wasnt clinically significant!). Also, anaesthetic inj apparently has higher risk of blood spot.

The Moorfields info sheet says topical or anaesthetic inj will be given but doesn't specify which or for whom. Perhaps they offer inj after drops have proven to be insufficient?

How experienced was your injector? To have 3 goes is not impressive. Good job you have 5 days of antibiotics - this will offset the increased risk of infection by their failure to get it done in one.

To ignore/ be frustrated with your pain is inexcusable. I know it's a pressure for the injector but keeping the patient calm and comfortable is part of their role.

Ozurdex takes longer than antivegf inj due to the angled entry and precise placement required - this is clear from Allergan literature and they should know!

I am shocked you went through this at Moorfields and I would be asking in writing via PALS for an explanation, and a reassurance that steps will be taken to prevent a repeat.

If your suspicions about using the wrong drops is true that flags a very serious error that needs nipping in the bud ( I suspect though they just used the basic method which the studies showed is ineffective for ozurdex). Either way they should surely have " topped you up" once your pain became apparent.

By going through PALS they cannot dismiss your concerns and any shortcomings of the injector will be addressed which will help others as well as yourself. I used the process myself and things vastly improved ( clinic manager apologised said dr was new to the role and accepted every point I raised as valid. I had same dr later and she had improved on all the points I'd made!).

Anyway, it's all done now, working steadily away for the next few months - best wishes for a good outcome x

kateanne profile image
kateanne

Thats exactly how I've been describing my black blob to friends - like a windscreen wiper! I have been finding eyesright's posts so helpful and this is a fantastic site to be on for enouragement. You know you're not alone when on here. Was so surprised when you mentioned Moorfield as I thought they were the gold star of hospitals! I would have chosen them over my own hospital if I ever needed more expert care but I suppose nowhere is perfect . Thank you for your kind comments.

Everything said above particularly by eyesright is valid. It ought not to have hurt. I have had many anti-VEGF shots but just 1 Ozurdex which I genuinely did not know had happened.

All clinics should have at least 2 different anaesthetic drops available in case of allergy issues.

In any future injection ask for the alternative to their usual one.

Poor technique is no excuse, Doctors and nurses practice extensively beforehand often using pigs eyes before being let loose on us!

I would certainly consider contacting PALS.

charlie_mk profile image
charlie_mk

Hidden Hidden kateanne

Thank you so much for all your advice guys. I have sent an email to the PALS service at Moorfields and am currently waiting to hear back.

Do you think I should remove this thread? I don't want to unnecessarily worry anyone else about to have their 1st Ozurdex!

I know that my experience was rare and unlikely to happen, so I don't want to freak anyone out! x

No, I'd leave it. Folk can see the responses which balance it.

It's important to know what isn't usual ( wish I'd known at my first one, I'd have spoken up at the time and saved myself immense trauma!).

Thanks for the thanks :) good luck with pals, let us know how you get on.

charlie_mk profile image
charlie_mk in reply to

I certainly will do, thank you.

The complaint had 9 different issues listed, so I feel it may take a while 😂 x

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