What is your safety record with AMD treatment?
What’s my safety record with AMD treatment? The most severe or significant risk is one of losing vision permanently due to sight-threatening infection, and the chance of that is approximately 1 in 1,000 per injection in general terms.
That is the quoted figure in the medical literature, and you see this figure cited widely. However, specifically relating to my practice, both in my private practice and in my broader NHS practice, I’m pleased to say that the risk seems to be lower. The risk per injection appears to be of the order of 1 in 3,000 or 1 in 5,000. So, significantly lower risk than the commonly quoted general risk.
One of the reasons for the lower risk of treatment could well relate to the expertise that I have delivering treatment for wet age-related macular degeneration, and the care and precision that I apply when it comes to preparing patients for the injection. Even though no one can eliminate the risk of infection, the drops we use and the technique we use to sterilise and clean the eye can make a big difference in helping to minimise the risk of site threatening infection.
What should patients look out for after an injection which could suggest a severe infection?
It’s quite common to have some soreness after each eye injection, and that discomfort happens once the anaesthetic drops wear off after a few hours. The drops we use to clean the eye before each injection cause the soreness. These drops usually contain iodine, and although this is the best antiseptic to prevent infection in the eye, it can lead to dry patches on the surface of the eye which can take a few days to heal completely.
If however, someone had pain after the injection which was getting worse rather than getting better or worsening vision or pain by looking at lights, then this could indicate an infection. Thankfully, the risk of infection is very low (between 1 in 3,000 to 5,000), but it is still essential to be aware of the symptoms which could indicate this problem.
Other mild side-effects can include redness on the white of the eye, and this can relate to bruising or bleeding from the tiny blood vessels on the surface of the eye at the time of the injection (a bit like when people get a small bruise when they have a blood test). This redness does not need treatment and will generally settle down over a few days or weeks.
Very rarely other problems can happen after injection for wet AMD including retinal detachment or cataract. With retinal detachment patients tend to get sudden flashes of light or floating dots or haze in their vision while with cataract the vision can become generally dim or foggy. It’s important to contact the clinic reception team or secretary at the clinic you had your injection within 24 hours of the start of these type of symptoms after an injection.