Eylea - silicone

[smallpurplecat]

Hi,

My husband has his second injection today and now has a black blob in his field of vision. He is worried that it is silicone oil from the syringe.

Does anyone have any experience of this?

[Koalajane]

Hi, I think he has a floater which are quite common after injections and soon go smaller and disappear

[smallpurplecat in reply to Koalajane]

Thank you for your message.

He has gotten himself into a real state about this and thinking it is permanent.

I hope it is just a floater.

[Koalajane in reply to smallpurplecat]

I would say to leave it to see if it goes smaller and if not to contact the eye clinic who will be very helpful

[Hidden]

Hi, often the actual inj fluid can appear like a blob ( mine looked like shiny black polo mints for a few days).

There was a problem in the past with avastin and silicone as the wrong type of syringe was being used ( unlike other antivegf inj it doesn't come preloaded and had to be prepared locally) but I believe that has all been sorted now and the correct syringes are used for eye inj.

Doesn't apply to lucentis or eyelea so if he's had either of those it definitely wont be silicone.

The macular society has info on floaters I think on their website.

[Hidden in reply to Hidden]

Probably nothing more than an air bubble. It will appear to be at the bottom of the eye but because it is behind the lens it appears upside down.

Normally, these disappear within a few hours.

I have had a couple of them.

[Hidden in reply to Hidden]

Think your reply was for smallpurplecat? But I agree x

[Hidden in reply to Hidden]

Sorry, small print! 🙄

[smallpurplecat in reply to Hidden]

Thanks for your reply.

Is that definitely the case about Eylea injections not having silicone oil..?

I was looking last night and the Bayer information sheet about Eylea says:

Pre-filled syringes:

Each carton includes a sealed blister pack with a sterile 1 ml colourless pre-filled type I glass syringe, containing an extractable volume of 90 microlitre solution for injection, sealed with bromobutyl gray fluoropolymer elastomeric plunger stopper siliconised with silicone oil and a tamper-evident bromobutyl gray elastomeric tip cap that is part of a closure system with Luer lock adaptor. The syringe has a pre- attached plunger rod and a finger plate.

Do the NHS use pre-filled syringes..?

[springcross in reply to smallpurplecat]

Yes, they do.

[Hidden in reply to smallpurplecat]

Hi smallpurplecat, I googled the thing about avastin and it was silicon coated needles that were used that caused the problem. This is completely different to preloaded eyelea syringes.

I've copied below an extract from a legal firm about the US class action lawsuit re avastin that explains it:

".....when ophthalmologists began asking pharmacies for it (for off-label use), the pharmacies often packaged Avastin® in syringes that were NOT appropriate for use in eye injections.

These syringes that pharmacies filled with Avastin® (which is a liquid) had needles that were often coated in silicone oil.

This silicone oil coating is common with syringes that are used for diabetes (ie. insulin shots), but should have NEVER been used with a needle meant for injection into an eye.

The Silicone On The Syringe Inadvertently Mixed With the Avastin® Liquid – And Thus Silicone Particles Were Unknowingly Injected Into The Patient’s Eyes

You see, the compounding pharmacies that would package Avastin® in syringes for off-label eye injections were careless in their use of silicone-coated needles.

The syringes were typically frozen for shipment, and later thawed at the ophthalmologist’s office. When you freeze a silicone oil-coated syringe and thaw it, silicone particles will then detach and mix with whatever liquid is in the syringe.

With non-eye related injections (like diabetic insulin delivery), this isn’t a big deal. The body can deal with some silicone particles being injected into the bloodstream without much problem.

But when those silicone particles are injected into the eye, they have NO WHERE to go, and no way to easily be removed.

Even worse, the silicone particles are injected directly into the patient’s line of sight – which is why so many Avastin® eye injection patients are seeing “floaters” and bubble-like spots in their vision. "

Hope that helps put his mind at rest.

[tallyho]

Hi there I am pretty sure it is an air bubble from the syringe it will go mine look like a blob of ink from an old ink pen. They are quite common I have had well over 100 injections now for DMO and so asked the same question and it is to to with air in the syringe which is very hard to avoid.

[smallpurplecat in reply to tallyho]

Thank you for your reply. I hope that is the case!

[Joankelley in reply to tallyho]

Do you get Eylea or Avastin injections?

[tallyho in reply to Joankelley]

I have Eylea, over the 9 years I have had avastin , lucentis and now Eylea

[Joankelley in reply to tallyho]

Thursday I will get my second Eylea injection. i have diminished vision with CRS in my other eye, so I am very worried about

getting those blobs. With your experience of 100 injections you are assuring me they will go away, right? Can u estimate about how frequently did the blobs happen?

[tallyho in reply to Joankelley]

Blobs after the injection are just air from the syringe they go for me very quickly within a few hrs. If you get floaters they may take longer but within 24-48 hrs at the latest in 9 years I have had 1 floater. Let me know how it goes.

[Becky_MacularSociety Partner]

Good Morning smallpurplecat,

As others have said, it is the injection fluid he is seeing, this is common following an injection. It should shrink and disappear within 48 hours but if it is still there, please contact the eye clinic.

Best Wishes,

Becky

Macular Society

[e-mail]

0300 3030 111

[smallpurplecat in reply to Becky_MacularSociety]

Thanks for your reply. I hope that is the case!

[springcross]

Hi. I had my Eylea injection this morning and I have two black blobs. It's the first time I have had any for quite a while but used to get them after the first four injections (also had black polo mints). It is just the fluid from the injection which will eventually disperse in a day or so.

[Rachmaninoff in reply to springcross]

Hi, I had 9 black blobs with my last eylea injection. I have been going for injections for about 3yrs and most of the time have only a couple or none at all. I treated them as floaters and relaxed. The following day I had 3 until only one tiny one was left. I was waiting for this to go and after a week I rang up my eye clinic. they asked me pertininent questions relating to possible serious symptoms to which I responded in the negative. It took almost 3 weeks for the last one to disappear. Administering eye injections varies from health carer - I am always relieved when I see my old faithful nurse is there to look after me!

[springcross in reply to Rachmaninoff]

Hi Rachmaninoff. We're not all the same and there will always be an exception to the rule and you did the right thing ringing the eye clinic as if it lasts that long, then it's always better to seek advice just in case. When I rang the eye hospital after my first one and they explained what it more than likely was, I just accepted it with the following injections and it turned out as nothing to worry about but had it gone on for a week then I too would have contact them (for reassurance if nothing else). x

[enopmar in reply to Rachmaninoff]

I play with my air bubbles, make them jump around, LOL. Move my head down and look thru it. Usually they consolidate and then go away.

[JJnan]

It's a floater, quite harmless, just a nuisance ...should disperse in a day or 2

...xxxxx

[Joankelley in reply to JJnan]

The blob is gone.....was there last night when I went to bed, but I just woke up, and it is gone! I am so thankful!

[enopmar]

It's either an air bubble, which will go away in a day, or the little silicone ring that sometimes comes from putting the syringe into the bottle. Unfortunately that hangs around for a long time, but eventually it will sink to the bottom and he won't see it.

[Becky_MacularSociety Partner in reply to enopmar]

Hey everyone,

Just to clarify, this is advice relating to the US. In the UK, they don't use silicone in the injections so it wouldn't be the case for UK patients, more likely to be the injection fluid, this is common following an injection. It should shrink and disappear within 48 hours.

Thanks

Becky

Macular Society

Advice and information

[e-mail]

0300 3030 111

[Jihm in reply to Becky_MacularSociety]

I guess then there have been no syringes manufactured in the US used in the UK because all US made syringes of any type use a silicone lubricant, not on the needle of course. But can silicone lubricant sometimes find its way onto the needle? Yes.

[Spottedog]

I understand your concern. I had the same reaction after my injections. However, I did get a silicone deposit in my eye . It hampers my vision as it floats around often when I need to focus on a particular area. I mentioned this to my doctor and he looked for it but couldn't find it. Well, it's still in my eye raising havoc on a daily basis. My doctor said I could have surgery to remove it but if he can't find it that doesn't sound promising. My doctor said the only other option is to skip the injection , which he wouldn't recommend. I just hope it does settle in an area that does't impede my vision. It's been 3 months and it's still visible. I hope this isn't the case for you.

[Joankelley in reply to Spottedog]

Did you get Avastin or Eylea injection?

[Spottedog in reply to Joankelley]

I got Eyelea

[Joankelley in reply to Spottedog]

The blob is gone! I had it when I went to sleep last night, and this morning, in less than 24 hours, it has disappeared! I want to say my central vision is perfect right now, both for reading and for distance.

I wish you the same good luck. From all of my research, I think Eylea might be the best medication to prevent WMD from progressing.

FYI. Upon examination of my eye, my dr. told me the leakage I have under my macula is fluid, not blood.

[Spottedog in reply to Joankelley]

I am so happy for you. Hearing good news is fantastic.

[Hidden in reply to Spottedog]

Hi spotteddog, can I ask how you know its silicone and not a " normal" floater?

The two look very different to the dr looking through the slit lamp but I wonder how the patient sees it? Thanks

[Spottedog in reply to Hidden]

It is a solid black dot that floats into my field of vision. I have to look toward the left, right or up or down to move it out of the way. At first I thought it was a speck on my sunglasses, then a speck on my windshield. I stopped my car and looked at elsewhere and realized it was in my eye. Since that first sighting,it has remained with me. It is difficult at times when trying to read and it floats in the way.

[Joankelley]

I just returned from my second Eylea injection. Last month I did NOT get the floating black blob, but this time I see the blob which has descended to the bottom of my vision.

Everyone is saying this is normal, and will go away, right? I did tell the nurse I hope my dr. would be using non-silicone syringes, and she said he uses the ones that are pre-packaged.

I need some reassurance, please.....would sincerely appreciate it if someone would share their experience about the blob with me. Have you found this blob is normal with your EYLEA injection, and how long did u have it?

And..........what did anyone do if did not go away?

With much appreciation for your reply, thank you.

[smallpurplecat in reply to Joankelley]

Hello,

How are you doing now?

My husband has his second Eylea injection on 1st April

He had the black blob in the bottom

of his vision and it suddenly disappeared

about 18 hours after his injection. The Dr said it was an air bubble.

He has been left with a big floater though.

He is due to have his third injection at the end of the month but he is feeling very worried about having another one.

[Joankelley in reply to smallpurplecat]

This was my 2nd Eylea injection. My vision is actually perfect right now, but the blob is still there. It is at the bottom and bounces around. If this is the trade-off for good vision, I think I could probably live with this blob. Will post a message if and when it goes away....I am hoping that might be tomorrow.

[Hidden in reply to smallpurplecat]

Hi smallpurplecat, its important hubby has all 3 as that's the loading dose. Gives best chance going forwards. X

[Joankelley]

In my research, I thought those blobs are more common with Avastin, not with Eylea, so I was disappointed. Same dr. gave me the injection at 8:30:this morning, and it is 7:00 PM, no change, it’s still there at the bottom . Will let you know when it is gone.

Good news, my vision is perfect, I can read the smallest print, and the distance vision is sharp and clear.

[smallpurplecat in reply to Joankelley]

I hope it disappears soon.

[Joankelley in reply to smallpurplecat]

Great news! I just woke up, and the blob has disappeared!

My prayers were answered.

Many thanks for your message.

Today will be a good day.

[smallpurplecat in reply to Joankelley]

So pleased for you. I think they are air bubbles...?

[Joankelley in reply to smallpurplecat]

Thank you so much. While it was annoying, I think I could have lived with the blob because it was at the bottom.....but am so happy it is gone. I must say i do have good vision right now, have clear central vision on reading, and distance is fine wearing my glasses. My dr. scheduled my 3rd Eylea for May, so that should be what they call “the load”, and then he said I may be able to stretch out the injections to longer intervals.

I hope you are doing well, too. It is such a comfort to be able to reach out to others to share these experiences. Good sight is so precious, most especially for me since I have Central Serous Retinopathy in my other eye.....there is nothing dr. can do to fix that.

[Joankelley in reply to smallpurplecat]

I think you are right, the blob was an air bubble. I cannot tell you how happy I was when I woke up this morning to have that blob gone. Next month I will get the 3rd Eylea injection to complete the typical “3 month load”, and at that time my dr. will evaluate to see if the interval can be longer, maybe every 6-8 weeks until the next injection. I am sure I will have injections forever, now.

I can tell you my central vision is excellent. Dr. said the leakage under my macula is fluid, not blood, so that is good.

This forum is a wonderful place to share our experiences and the journey to saving our sight. I thank you for your post.