Different approaches to delivering injections

[Catseyes235]

I sometimes wonder if there is ‘best practice’ in delivering injections or is it always down to the individual practitioner. Last Friday I had the same person give me injections as one time when it took 5 days to recover. She is very kind and takes her time, explains every move, cleans well. and even moved the clamp when it was really uncomfortable. Despite this I again had some bruising and grittiness. (It didn’t help that I had some allergic reaction to something, face mask, gloves ? and had to take antihistamine). Still feels a bit tender after three days.

The last time I had injections, also under lockdown, was with a male doctor I’d never seen before who was very quick and efficient and not a lot of chat. I came out not requiring any further drops at all and perfectly fine! I’m wondering if the shorter time gives the best results as it means less exposure to the iodine, the clamps, the gloves etc .

Any thoughts?

[Koalajane]

I have to say I prefer female injectors. My last one was lovely and gave me extra numbing drops and explained everything. I had both eyes injected and usually my left eye gets really gritty after but not this time. I had no problems with either eyes.

I really like to know what they are doing as you can’t see what is happening behind you. I also think it helps if they wash out the iodine well after.

[Catseyes235 in reply to Koalajane]

Most of the people doing the injection are female. The first time I had an injection the nurse didn’t use the clamps but a kind of sticky cloth that was then parted and held my eye open. I actually felt nothing! It was quite a shock to then have clamps used. I think that’s the worst part sometimes and the slower someone is the longer you have to put up with them. One man was over chatty and never stopped talking - he said it was to put patients at ease..Hmmm not sure. But no discomfort after that one.

[springcross]

I have found that my regular injector (male) causes me more discomfort than others have done. He overuses the iodine wipe almost every time in spite of the opthalmologist putting on my notes not to do it and to flush out well afterwards and he almost always causes a bleed. I have had three other injectors, each of them once only and all women. The first one was very pleasant but caused me to feel everything from start to finish and also hit a vein which caused my eye to look a real mess for about a fortnight. The other two (one of them a doctor) were excellent and I had no iodine discomfort afterwards because they didn't go overboard with it, the numbing of my eye was very successful with them as was the actual injection. My last injection on 23 July with the usual male injector was another nightmare - I knew when I got up from the seat that I was in for trouble. My eye was immediately sore as he had gone overboard with the iodine again and although he flushed it out afterwards, I still had the soreness, the runny nostril and constantly running eye and yet again, he hit a vein and it took two weeks for all the bloodshot redness to disappear. Also, after I got home I was dabbing the corner of my eye to dry it as it was running and the gauze had yellow on it so although he flushed the iodine out afterwards, I still had some of it left in there.

[Catseyes235 in reply to springcross]

Actually when I removed hospital mask (they issue a replacement for your own when you arrive) I noticed the edge was orange, perhaps tinged with blood as lower white of right eye still bloody. May have been iodine? I have had a reaction to latex in the past. Oh well I daresay I’ll find out one day. Someone had said there was a male who was awful but luckily not the ones I’ve seen!

[springcross in reply to Catseyes235]

Yes I had a replacement mask too the nurse advised it so that mine didn't get iodine stains on it. The orange would have been the iodine, that's why you were offered a replacement. xx

[Catseyes235 in reply to springcross]

It’s hospital COVID policy regardless of treatment so you’re not bringing anything in on your old mask. Temperature check and hand gel on the way in too. I pity the receptionists, who luckily do have masks, when people feel they have to take mask off and lean over or through the gap in the barrier that to give their name! Mainly elderly :(. Eyes washed out three times each but maybe dribbled below the mask.?

[springcross in reply to Catseyes235]

Just goes to show how different some places are. At my last injection were all sat in the waiting area (adequately spaced) wearing our own masks and even going in for the chart test and OCT scans wearing our own masks but only being asked if we would like to swap for theirs in the injection room, hand wash is readily available throughout too. On saying that, this is rooms in another hospital (not in eye hospital) which are only used for injections two or three days a week. I must admit though I was surprised that we were not stopped at the hospital door and told to take our masks off and put theirs on as happened when I attended the actual Eye Hospital for the previous injections. I understand what you mean about receptionists. I'm glad that temperature checks are on their way in and I feel that it should already be happening, they've had plenty of time to bring that in, in my humble opinion.

[Catseyes235 in reply to springcross]

I went for a meal two weeks ago and even then we had temperature checks and hand gel at the door and all staff wore masks so felt fairly safe. Another friend went to a riverside pub where no masks worn and were talked to by young waiter and felt very insecure.

I had my injections done in main operating theatre of eye hospital. That felt strange! Guess they are doing their best but consistency would be nice!

[springcross in reply to Catseyes235]

I agree.

[Penelopeflower]

Hello, in my experience the injections do vary with the practitioner who gives them, sometimes the eye does feel a bit gritty, and other times you hardly notice any problem at all, also it depends a lot on how well the eye is rinsed, especially when iodine is used, and if you have lots of numbing drops that helps a lot too. Good luck with future injections.

[Hidden]

Definitely makes a difference who does it. Also I find upper part of eye more sensitive than lower but most of my inj have been in upper.

Quick and quiet is best ( as long as enough time given for anaesthetic to work), less time for eye to dry out and it's not good practice for anyone to talk over patient or instrument tray as raises infection risk.

Insist upon more anaesthetic drops and a thorough wash out.

[Catseyes235 in reply to Hidden]

Ha ha Totally agree but not in a great position to say ‘cut the chat’ or ‘just get on with it’!! I just wonder if practitioners get (or welcome) feedback to find what is best for patient. I’ve never been asked.

[Fishing1949]

Since my consultant replaced the iodine with chlorohexadine I have had only very minimal discomfort following the last eight injections of Eylea. I also have antiseptic drops for seven days following each injection. You could discuss this with your doctor as an option. I hope this is helpful.

[Catseyes235 in reply to Fishing1949]

Thanks, I certainly will. Maybe I need allergy test. Experience so varied and she washed eye out with 3 good things flushes each eye but not sure if mopped up around surrounding skin because of mask. Allergic reaction was strange though after 4 years of treatment? Flushed and red nose and cheeks and couldn’t breathe through nose which ran and ran for hours! Thank goodness I had antihistamines to hand.

[fed13]

I had similar experiences. It was iodine that was the culprit, so I was switched to 1/2 strength iodine, which helps enormously! I am so sorry you are suffering so, Catseyes; do discuss with them either switching to chlorohexidine or 1/2 strength iodine. Good luck! xx

[Catseyes235 in reply to fed13]

Interesting half strength iodine. Still wandering if latex gloves caused allergic reaction as similar to something I had years ago but with an eye op at Moorefield’s? At the time it was thought it could be penicillin but in the end it seemed not so down to that elasticated plaster ? Ah well at least I recovered with a couple of antihistamine. Thanks for your thoughts.

[JJnan]

I think it is down to who does the injection...they have trained the nurses to do injections now, just wish they were all on same page.....1 in particular didn't ask to look up or down when putting clamp in just struggled it was awful..she never said a word to me .....sore eye for 4 days...mentioned it to consultant who informed me it was one of the Doctors!!....I had a terrible reaction to the 'drape' being to sticky, and removed with a tug!...very sore red eyelid and eye ...I refused to have drape after that ...it's in my notes ...but still get told I should!...when it's an excellent injection I want to be able to say...why can't you all be like this...!...

I have found though if you speak up ( nicely)...your classed as a moaner sadly ...we are our own advocates and our eyes are most important ....is it to much to expect to have it done without suffering ...we have no temp taken ..no antibiotic drops to go home with ......I'm sorry for you Catseyes ... explain to the consultant about it ...hope it improves ...good luck xx

[Catseyes235 in reply to JJnan]

That is awful - Dare I say it’s not rocket science but a series of procedures that can be carried out well .. or not. I’m absolutely fine now apart from one eye still looking bloodshot - I could have been a Zombie extra! hopefully one more injection in left eye will bring them to the same level. Then hopefully back to longer gaps. My last injections were postponed as I had a small stroke and without treatment for 19 weeks my eyes did really well.

I think we should complain but I know what you mean - you’re very vulnerable when someone’s about to stick a needle in your eye but if we say nothing they won’t improve.

Take care!