Episcleral injections are a specialized medical procedure in ophthalmology, designed to deliver medication directly to the eye. This method is a targeted approach for administering therapeutic agents to address various ocular conditions. It allows eye care professionals to treat specific eye issues by introducing medication into the tissues surrounding the eyeball.
This precise technique maximizes the medication’s therapeutic benefits within the eye while minimizing potential systemic effects. An eye care specialist performs the procedure.
Understanding Episcleral Injections
An episcleral injection delivers medication into the episcleral space, located just beneath the conjunctiva and on the surface of the sclera, the eye’s white outer layer. This strategic placement allows direct access to ocular tissues. Common medications include corticosteroids for inflammation, anti-VEGF agents to inhibit abnormal blood vessel growth, and antibiotics.
This delivery method is chosen for several reasons. It enables targeted delivery, ensuring a higher concentration of medication reaches affected ocular tissues. By localizing drug delivery to the eye, this method helps avoid or significantly reduce systemic side effects common with oral or intravenous administration. Episcleral injections can also provide a sustained therapeutic concentration of the drug within the eye.
Medical Applications
Episcleral injections are employed for a range of eye conditions where localized drug delivery is beneficial. For instance, in uveitis, an inflammation affecting the middle layer of the eye, corticosteroids delivered via episcleral injection reduce inflammation and swelling. This targeted anti-inflammatory action preserves ocular structures and function.
The injections are also utilized in managing certain retinal conditions, such as macular edema, where fluid accumulates in the macula, leading to blurred vision. Episclerally delivered anti-VEGF agents inhibit abnormal blood vessel growth and reduce leakage, common in conditions like diabetic macular edema or neovascular (wet) age-related macular degeneration. This helps stabilize or improve vision by addressing underlying vascular issues.
Additionally, episcleral injections can play a role in the management of scleritis, an inflammation of the sclera, and sometimes in specific forms of glaucoma. In scleritis, corticosteroids may be used to calm the inflammation. For certain types of glaucoma, agents like hypertonic saline can be injected into episcleral veins to influence intraocular pressure. The specific medication chosen for an episcleral injection is determined by the patient’s diagnosis and the desired therapeutic outcome.
The Injection Process
An episcleral injection involves several steps, typically performed in an ophthalmologist’s office. Before the injection, the eye area is prepared for sterility and comfort. This includes applying numbing eye drops to anesthetize the eye’s surface and cleaning the surrounding area to reduce infection risk.
During the procedure, a fine needle administers medication into the episcleral tissue. The eye care professional identifies the precise injection site, which varies based on the condition and medication. The injection is quick, lasting only moments. After administration, gentle pressure may be applied to help distribute the medication and prevent minor bleeding.
After the Injection
Following an episcleral injection, patients can expect some common, temporary sensations and minor effects. It is typical to experience temporary redness at the injection site, mild irritation, or a gritty feeling in the eye for about 24 to 48 hours. Some individuals might also notice small specks or floaters, which are usually tiny air bubbles introduced during the injection and tend to disappear within a few days.
Post-injection care instructions are provided to support healing and minimize potential issues. Patients are generally advised to avoid rubbing the injected eye and to refrain from activities such as swimming for about a week to prevent infection. It is important to continue using any other prescribed eye drops as directed by the eye care professional.
Monitoring for any unusual symptoms is an important aspect of aftercare. While mild effects are expected, it is advisable to seek prompt medical attention if there is severe or worsening pain, significant changes in vision, or any signs that might suggest an infection, such as increased redness, discharge, or sensitivity to light, especially if these symptoms persist or worsen after the initial 48 hours. Follow-up appointments are routinely scheduled to assess the eye’s response to the treatment and monitor progress.