Help for painful injections

[Shimano]

The terror d distress of those of us suffering excruciatingly painful injections seems to be ignored though I note some of the heartfelt pleas for recognition of this problem go back At least six years on this site. The claim that they are painless and only pressure is felt does not apply to everyone. Is any reseArch At all being done to improve anaesthesia for those of us torn between fear of going blind and fear of the injections.

[tallyho]

I am interested as to what you have tried to stop the horrid pain. I have had injections monthly for 10 years now what has really really helped me is having a drop or 2 of celluvisc which I put in myself just before I go in for the injection and the difference has been amazing. The celluvisc is given to me by my clinic they give me a box of it when ever I want it. I live in the UK and have DMI not AMD tho the treatment is the same.

[Shimano in reply to tallyho]

Thanks for your response tallyho. I have a gel called Clinitas which I use after the injection to soothe the dryness and discomfort. I wonder if this is similar. I was told not to use it prior to the injection. It is Carbomer 0.2%.I will ask about using it prior to Injection. After two years of injections for left eye my right eye has now also gone wet so the thought of twice as many painful injections is pretty grim. Best wishes.

[thom3patty]

I too suffered from excruciating pain after injections and I saw on here several people received numbing drop AFTER the injection too this was a game changer for me my dr agreed to let me have and it is now tolerable I get a heavy eye wash some gel and an extra numbing drop at the end before this I was vomiting from the severe pain hope this helps and what r the drops u r taking? R they numbing drops or moisturizer drops? Thanks

[Shimano in reply to thom3patty]

Thanks thorn3patty. Since iodine, to which I had allergic reaction, greatly reduced I don’t have the barbed wire experience after the jag. The gel I use afterwards is a moisturiser for extreme dry eyes after the numbing drops prior to the jags. It is the actual injection which can be excruciating and which I dread. All the leaflets say it is painless. Not for me it ain’t! Hope things get better for you.

[ironbrain]

Tetracaine is said to be more potent than anything else used. Possibly there's slightly more chance of cornea damage with it (protein binding problem?), but if it's a case of it or going blind ...

Search for:

proxymetacaine OR proparacaine tetracaine

Here's one that comes up:

bnf.nice.org.uk/treatment-s...

This one suggests there's not much between them in practice:

assets.markallengroup.com/a...

[Shimano in reply to ironbrain]

I think it is lidocaine they use now after I asked for it, having had a tip on this site. I will certainly look up the sites you mention. Grateful for your response. Thankyou.

[ironbrain in reply to Shimano]

MREH uses, or used to use, proxymetacaine, "prooxy".

[Becky_MacularSociety Partner]

Good Afternoon Shimano,

Unfortunately some people do have a negative response to the injections. Quite often, this is because someone is sensitive or allergic to the iodine solution used on the eye. This can be helped by having a thorough washing out of the eye following the injection. Have you discussed this with your consultant? Your consultant should be able to help figure out how to reduce the pain you feel to make the treatment more comfortable for you. Whether it's washing you eye more thoroughly after injections, or looking at other factors such as the amount of anaesthetic, or providing some pain relief for afterwards.

If you send us an email at [e-mail] we can send you a factsheet about Painful injections which can help bring up some talking points with your consultant

I hope this helps

All the best

Becky

[Shimano in reply to Becky_MacularSociety]

Dear Becky. Thanks to advice from this site I have sorted out the iodine problem which left me with an eye full of barbed wire for nearly 24 hours. It is the actual injection which can be truly Awful and leave me shattered. I have had a couple which were bearAble from a young and very patient doc. Would be grateful for Any information and will e mail you. By the way, this macular society site is An invaluable source of information And support. It is really helpful.

[alcheeg]

It's really not a painful procedure, actually its "fear of the unknown" and it sounds worse than it really is. Lots of pressure and beforehand emotions about "what if......................" I guess its something we have to do because we are at the mercy of doctors, hoping they know what they are doing.

[Shimano in reply to alcheeg]

Disagree alcheeg. It’s actually fear of the known in my case. My first half dozen jags were horrendous both during and afterwards. Now just during, though I have had two which were less awful. Glad you don’t experience them as painful though.

[alcheeg in reply to alcheeg]

I'm sorry Shimano that you are going thru such painful experience. I guess every body is different and it depends on who your doctor is and where you are located. Here's for better service for you and all of us in the future!

[Shimano in reply to alcheeg]

Thanks alcheeg. Go well.

[alcheeg in reply to Shimano]

I have been getting shots for about 2 yrs now and the doc use to patch up my eye for 24 hrs to avoid infections. However on the last two visits he did (at my request) stop the eye patches and I was a little more comfortable. But now on my last visit after the shot I have a tiny black spot, looks like a fly, and it keeps floating. I hesitated calling the doc because its hard for me to get a ride to get there and I know doc will say "come in." So I finally called and asked for his helper and when I described what I have she said that's normal. So at least I tried and will wait for my next appointment which is in Sept. There's no pain but its very annoying to have a tiny fly in front of your eye all the time. Did u ever have anything like this?

[Shimano in reply to alcheeg]

Yes alcheeg, I sometimes try to swot them!!! I think they are just floaters. A floater is just Organic bits of rubbish-in the eye. Sometimes they get reaasorbed and sometimes not. Thank you for your sympathetic good wishes which are sincerely returned.

[Catseyes235 in reply to alcheeg]

It’s at the injection site and they usually fade in time but I have got some tiny permanent ones that I only notice when looking for high flying birds but I’ve learnt to tell the difference between a buzzard and a black dot!!

[Ayralin in reply to alcheeg]

Hello. The "black spot " is an air bubble. The needle sometimes has a bit of air in it and gets injected into the eye with the medication. It is usually absorbed in 24-48 hours. It floats to the top of the eye. But our brain flips it over. It floats around with your head movement. It is harmless.

[alcheeg in reply to Ayralin]

Thank u Ayralin for your comments "its harmless!" It does move around with my head. But u made me feel better about it. I think the doctors would never tell us the real reason these things happen. When I called the office and spoke w/his assistant she said "its nothing" it happens. So much for an answer But I'm glad she did not say "come in" then I would be really upset. It's hard for me to even get a rider to take me for shots. Thank you It's so nice talking w/people who have the same problems. God Bless Us All!

[3furryfiends in reply to alcheeg]

I disagree with you! I had 6 injections with no pain and then they scratched my eyeball and now the pain is awful. It therefore is not fear of the unknown!! because of the scratches I lost the sight in my eye for several minutes and ended up in emergency dept- I know that everyone is different and has a different pain threshold but when damage has been caused there is intense pain and it is very upsetting as no-one will listen to you.

[alcheeg in reply to 3furryfiends]

Sorry to hear that and it does sound awful. I think we are always afraid that the doctors are going to break or damage us while they are probing. Best wishes to you to get back to normal.

[RP1944 in reply to alcheeg]

It might not be painful to you but to many of us the jab in the eye is extremely painful and we dread the jabs. It’s only the thought of going blind that makes me persevere with the jabs.

[Shimano in reply to RP1944]

Thanks for sharing this RP1944. Exactly how I feel too. Going blind is awful but especially if you live alone . Hope you have family near at hand. All the best.

[RP1944 in reply to Shimano]

Thank you. Yes I live on my own but family live very nearby but I dread losing my independence.

[MexLiz]

Lidocaine gel is the only thing that has made my injections tolerable! The doctor applies it before the injection and now I feel mild pressure and a microsecond of pain. Depending on which country you live in, the gel has different names. But look for 2% lidocaine gel. Good luck.

[Shimano in reply to MexLiz]

I get lidocaine jag prior to eylea jag as well as numbing drops. I have had one jag which was as you describe it . I could tolerate it if that was every time. appreciate your response. Thank you and good luck with your treatment.

[jwitts]

I can't help wondering how much is due to the skill and technique of the doctor. My ophthalmologist not only uses numbing drops, but a quick injection of some kind of analgesic ahead of the primary injection. She said she began doing this because she noticed the fear and suffering of many of her patients when they came in for their shots. She was reluctant at first, because using two injections could increase the possibility of infection, but there have been no infections in her practice so far and many of us have been seeing her for years. (And we love her!)

[Shimano in reply to jwitts]

Gosh, no wonder you love her. I am also now getting the drops And the anaesthetic jag prior to the injection. The twice they have helped a lot was When I had a lovely young female doc who was extremely gentle. I wish I could have her all the time. I know they are reluctant to risk infection. It’s wonderful you have someone who sees the suffering is real and the dread is justified. It’s not as if it’s a one off you have to get through, it’s for life. Really appreciate your response. Thankyou.

[jwitts]

Yes, the affect and skill of the person giving the shot is helpful--and especially if she's lovely! Hope things go better for you.

[Catseyes235 in reply to jwitts]

Funnily enough one of the worst injectors is a really sweet woman - the epitome of kindness and patience but she takes tooooo long explaining everything then delivers the injection soooo slowly so it’s really difficult not to blink which of course leaves your eyes bloodshot! She asked if I’m taking blood thinners and tried to blame that for the bleeding but I’ve had other injectors who have been fine.

[3furryfiends]

I had 6 injections with no pain or problems and then on the 7th injection the injector scratched my eyeball with the clamp!!! several times !!!!! and since then I have had awful pain and discomfort. I went to the emergency dept as I also lost the sight in the eye for several minutes. They have tried eye washes after the injection, extra numbing drops and not using any form of iodine/betadine but the pain still continues. I have taken photos of the swollen eye. My eyelid swells up- i look like I have been in a boxing match. My eye goes red and waters for a few days after every injection now. I apologise now for my language when I have the injection- It s difficult to put into words the level of pain I feel. I tell the injecting team to imagine they are having their front teeth filled without being numbed!!and that's how I feel. You are correct to state the skill of the injector is very important.

[Shimano in reply to 3furryfiends]

Nobody could know how bad it can be if they haven’t experienced it…..and how the dread of the next jag eats into your life. It’s great that many people don’t suffer like this but that doesn’t mean those who do should just be shrugged off. I do hope things improve for you furryfiends. It sounds truly awful.

[Catseyes235 in reply to 3furryfiends]

Luckily I’ve never been scratched but I know how painful it is as it happened frequently when I had Thyroid Eye Disease. I do hope it resolves itself.

[jwitts in reply to 3furryfiends]

So sorry this happened to you. My doctor doesn't use a clamp. Just tells me to look up and then the needle is in and out in seconds.

[jwitts in reply to 3furryfiends]

I think another thing that seems to be different in my experience is that it's always the same doctor giving the injection. She understands all her patients well. I swear she knows how fast I blink! I wish everyone could have the same experience.

[Hammiepaeroa]

It's put me right off having these terrible injections when it's my turn. Hopefully something more pleasant will be available.

[Catseyes235]

I’ve been having injections about 4 years and have had varied experiences as some seem to think that if they give a certain amount of anaesthetic that should be enough. Not true. We’re all different. What my best injectors do is ask if I can feel the intended injection spot and don’t give the injection until I feel nothing. So now I tell them if I can feel anything although the last one was a bit painful as I didn’t have a chance to say anything this time .

What really annoys me is when they say ‘sharp scratch’ as though they’re giving an ordinary injection!! There are two nurses who have never caused pain or flinching and I wish they could teach the others! If only we got a post injection questionnaire to award points ...!

[Shimano in reply to Catseyes235]

Good suggestion cAtseyes. Also, It would make a good research project for a student opthamologist to correlate feedback after injections so that good, kind injectors can set the standard.

[Seamus1]

Excellent point. I am now on injection 27 & 30. After initial injections I requested extra irrigation, this eased the post anaesthesia pain, in some cases nullifying it completely.

Last week I attended the clinic after 2 years of mostly pain free procedures, a new doctor was doing the injections, I politely asked for extra irrigation, grudgingly he agreed, but did not listen when, after some irrigation I stated I could still see a light brown ring. Later that day the pain was intense, I phoned the clinic and received an appalling response, “ well you don’t have to have the injections “!

What can you say in response to that?

[springcross in reply to Seamus1]

Hi Seamus1. I'm sorry to hear what was said to you - that's a dreadful response and in my opinion, should be reported to your ophthalmologist before your next injection or a letter dropped in to the consultant. Staff should not be allowed to get away with it - maybe they should have a taste of what injections are like as it may make them look upon our reactions in a different light! Hoping your next one will be pain free. 🤞

[Seamus1 in reply to springcross]

Many thanks for your kind words. I have already spoken with the consultant and the individual will be advised! Good luck with your treatment

[springcross in reply to Seamus1]

I'm so pleased to hear that Seamus1, well done to you. Thank you for your good wishes and the same to you too.