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doi: 10.1097/IAE.0b013e3182252ad3
Original Study

Factors Affecting Patients' Pain Intensity During in Office Intravitreal Injection Procedure

Rifkin, Lana MD; Schaal, Shlomit MD, PhD

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Purpose: To determine factors associated with patients' comfort during routine in-office intravitreal injection.

Methods: Sixty patients receiving intravitreal injections over 15 months for macular edema because of diabetes, age-related macular degeneration, or retinal vein occlusion who were randomized into 3 groups to receive 1 of 3 commonly used forms of anesthesia—TetraVisc, proparacaine HCl, or tetracaine HCl—before receiving intravitreal injection were studied. Fifteen minutes after injection, patients were asked to rate their pain from 0 (no pain/no distress) to 10 (agonizing pain/unbearable distress) using a Visual Analog Pain score survey. Self-reported pain scores were stratified by age, gender, diagnosis, injection number, substance injected, needle gauge, and visual acuity improvement.

Results: Intravitreal injection was associated with low pain scores. Patients receiving tetracaine reported a statistically significant lower pain score (3.05 ± 2.01) than patients receiving proparacaine (3.17 ± 2.18) or TetraVisc (3.3 9± 2.26; P < 0.01). Other important factors influencing pain score significantly (P < 0.01) included improved vision from previous injection, female sex, and age >65 years. Pain scores decreased with each consecutive injection.

Conclusion: Pain associated with intravitreal injection is generally mild, and may be associated with epidemiologic and environmental factors.

© The Ophthalmic Communications Society, Inc.


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