Intravitreal Injection: Is it painful?

An explanation of the steps involved in an intravitreal eye injection within the sterile operating room, the type of topical anesthesia used, and why the patient does not feel any pain.

Intravitreal Injection: Is It Painful? A Scientific Fact That Reassures Patients

Intravitreal injection is a vital medical procedure that has revolutionized the treatment of many serious retinal diseases, such as diabetic retinopathy, macular edema, retinal vein occlusion, and wet age-related macular degeneration. Despite its high efficacy, merely mentioning the word "injection" might raise concerns among some patients about the possibility of pain. In this article, we explain in detail how intravitreal injections are performed, what measures are taken to ensure patient comfort, and why this procedure is considered almost pain-free.

What is an Intravitreal Injection?

An intravitreal injection is a medical procedure in which a specific medicine is injected directly into the vitreous cavity of the eye. This cavity is a large space filled with a transparent, jelly-like substance (the vitreous humor) that fills the back part of the eyeball. The goal of direct injection is to deliver the medication at a high concentration to the affected tissues in the retina or macula, allowing it to work more effectively and reduce potential systemic side effects compared to medications taken orally or intravenously.

Why Do We Need Intravitreal Injections?

This technique is used to treat a wide range of conditions affecting central and peripheral vision, including:

Diabetic Retinopathy and Diabetic Macular Edema (DME): where abnormal new blood vessels cause growth and fluid leakage in the retina.
Wet Age-Related Macular Degeneration (Wet AMD): growth of abnormal blood vessels under the macula leading to fluid leakage and central vision damage.
Retinal Vein Occlusion (RVO): such as Central Retinal Vein Occlusion (CRVO) or Branch Retinal Vein Occlusion (BRVO), leading to bleeding and swelling in the retina.
Posterior Uveitis: where injections can deliver anti-inflammatory drugs directly to the site of inflammation.
Certain complex post-retinal surgery cases such as vitrectomy or retinal detachment repair.

Steps of Intravitreal Injection: A Journey Towards Pain-Free Recovery

Intravitreal injections are performed in a completely sterile environment, often in a well-equipped operating room or specialized clinic to ensure the highest safety standards and prevent infection. Perhaps the most prominent feature of this procedure is the intense focus on patient comfort and minimizing any sensation of pain:

1. Effective Topical Anesthesia: The Secret to Not Feeling Pain

Before beginning the injection, the doctor applies strong topical anesthetic drops to the surface of the eye. These drops quickly numb the cornea and conjunctiva, which are the areas where the needle will be inserted. In some cases, the doctor may use a very small amount of additional local anesthetic (such as lidocaine) around or under the eye, but in the vast majority of cases, topical anesthetic drops are completely sufficient. This type of anesthesia is very similar to what is used in cataract surgery with topical anesthesia (eye drops): no injections or pain, ensuring the patient feels no pain during the procedure.

2. Strict Sterilization: The First Line of Defense Against Infection

Cleanliness and sterilization are top priorities. The eye area and eyelids are cleaned with a strong antiseptic solution before injection. Completely sterile medical instruments are also used, often single-use, to ensure the highest levels of safety. This significantly reduces the risk of any complications, including infection.

3. Precise Injection Technique: The Expertise of a Retinal Surgeon

The injection is usually performed in a specific part of the eye, away from the sensitive central macula, and using a very fine needle. The retinal surgeon, such as Dr. Mahmoud Hassan, with his extensive experience in choosing the best retinal surgeon in Egypt, Sudan, and Yemen, determines the optimal injection site to ensure effective drug delivery while minimizing any potential discomfort. The patient may feel some slight pressure during the injection, but it is a transient sensation and not equivalent to pain.

4. Post-Injection: Simple Instructions for Complete Comfort

After the injection is completed, the patient may be asked to remain in a certain position for a short period, and antibiotic or anti-inflammatory eye drops may be given. The recovery period is usually immediate, and the patient can return to normal activities shortly after, while avoiding rubbing or pressing on the eye.

Why Doesn't the Patient Feel Pain? A Scientific Summary

The secret to not feeling pain during intravitreal injection lies in several integrated factors:

Effective Topical Anesthesia: Stops the transmission of pain nerve signals from the eye to the brain.
Very Fine Needles: The size of the needle used reduces the size of the wound and minimizes the prickling sensation.
Strategic Injection Site: The injection is performed in less sensitive areas of the eye.
Sterile Environment and Advanced Technique: Reduces the likelihood of inflammation or irritation that might cause pain later.
Surgeon's Experience: Such as the experience of Dr. Mahmoud Hassan at Mashreq Eye Center, ensures the procedure is performed smoothly and accurately.

It is worth noting that some patients may experience a slight sensation of pressure or transient discomfort, but this is completely different from acute pain. In very rare cases, complications such as a temporary increase in eye pressure may occur, but these are effectively managed.

Intraocular Injection Cost

The cost of intraocular injections varies depending on the type of medication used and the number of sessions required. For instance, the price for an intravitreal injection (IVI) procedure in Egypt for 2026 starts at approximately 7,000 EGP (estimated). For specific medications like Eylea or Lucentis injections, the price for an Eylea / Lucentis injection in Egypt for 2026 is around 9,000 EGP (estimated). Meanwhile, the price for Vabysmo injections in Egypt for 2026 is approximately 11,000 EGP (estimated). These prices are approximate and depend on the patient's individual condition and whether health insurance is available.

Al-Mashreq Eye Center: Where Expertise Meets Care

At Al-Mashreq Eye Center in Cairo, we are committed to providing the highest standards of care for retinal patients. Our medical team is led by a selection of experts, including Dr. Mahmoud Hassan, a key contributor to the development of retinal services at the center. We pride ourselves on offering the latest treatments, including intraocular injections, with state-of-the-art technology and under precise medical supervision to ensure the best outcomes and patient comfort. You can learn more about our services by visiting our website Al-Mashreq Eye Center.

If you suffer from any retinal diseases requiring intraocular injections, do not hesitate to consult our medical team. You can find more valuable medical information and advice on .

For booking and inquiries: 01002310813

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