Eye injection drugs. Injections in the eye: types and preparations for injection into the eyeball. How are eye injections done?

For many ophthalmic and neurological diseases, it is necessary to inject directly into the eyeball.

This is a rather painful procedure, so it is not performed at home.

It is carried out only by an ophthalmologist. For administration, various drugs are used to eliminate inflammation, edema and other pathologies. The method of piercing the eyeballs depends on the diagnosis, the need for a certain effect.

Classification of injections into the eyeball

There are different types of injections, for each of them the ophthalmologist supports a specific puncture site:

• Retrobulbarno. The needle is driven deep, to the middle of the eyeball. It is carried out through the edge of the orbit to the region of the lower eyelid. The medicine is distributed along the inside of the eyeball.
• Subconjunctival. The puncture is carried out through the lower eyelid, comes to the conjunctiva. The technique causes acute pain, so the ophthalmologist first uses a local anesthetic, instilling it three times with a short interval. For puncture, insulin syringes are used, which are directed with a cut to the surface of the eyes.
• intravitreal. The injection allows the drug to enter the vitreous body. Preliminary use of an anesthetic for local anesthesia.
• Parabulbar. Medicinal substances are injected through a needle, spreading to the fiber between the bone and the eyeball. The procedure is carried out through the lower eyelid.

The procedure is associated with an increased risk of complications. Therefore, the technique should be carried out only by a professional ophthalmologist.

How injections are carried out

All injection procedures are carried out in several stages:

1. opening a disposable syringe from the package;
2. opening the injectable, which is also disposable and sterile;
3. disinfection of skin surfaces to prevent infection from entering the puncture site;
4. the cap is removed from the syringe, the drug is drawn up, the resulting air is released;
5. the puncture is carried out at a certain angle, according to the chosen method;
6. the needle must penetrate deep enough to get into the necessary areas of the eyeball or the space around it;
7. slow introduction of the required amount of the drug;
8. the needle is taken out of the eyeball and skin surfaces;
9. the place of damage is wetted with cotton wool, while it must be moistened with ethyl alcohol or another disinfectant solution.

During the injection into the eyeball, all the rules of sterility must be observed.. The slightest penetration of pathogenic microorganisms into the sterile internal environment of the eyeball will cause infection. There is an increased risk of bacteria spreading into the bloodstream, which will lead to sepsis and death of the patient without immediate medical manipulation.

Does it hurt to get an injection in the eye

There are many nerve endings in the eyes and skin surfaces around them. Therefore, the puncture of the eyeball is a painful procedure. Before the injection, the doctor always does local anesthesia, for this the following drugs are used:

Use them only when necessary, as they can cause many adverse reactions. If the procedure is very painful or the patient is hypersensitive, instillation is carried out 2-3 times.

Injectable drugs

In ophthalmology, there are many varieties of drugs. Most often they are used in the form of instillation of external surfaces. But if the disease is serious enough, internal penetration of the drug through injections is necessary.

Lucentis

The drug is intended for diseases that extend to the retina. It relieves swelling from the macula. Lucentis can cause various types of allergic reactions, some of which can be life-threatening for the patient. Therefore, the dosage is limited

Eilea

The drug is used for pathologies of the retina, during macular edema. It is injected through the pupil, it directly enters the site of the lesion. The effect develops instantly. The process of damage to the vascular tissue is slowed down.

Kenalog

It is a hormonal substance based on corticosteroids. With its introduction, inflammation, swelling, and an allergic reaction are eliminated.. The drug has a side effect in the form of an increase in intraocular pressure, so it is strictly contraindicated in glaucoma.

Ozurdex

The drug affects the quality of blood, eliminating the risk of thrombosis. Reduces the possibility of blockage of the vessels of the microcirculation of the eyes, as a result of which atrophy of the eyeball may develop. Additionally, it reduces inflammation and swelling.

Retinalamin

Retinalamin is used in the pathology of the retina, during its atrophy and inflammation.. Quickly restores damaged tissues, promotes regeneration. Normalizes metabolic processes in the affected area

Reaferon

It has the following effects after administration:

• stimulation of immunity;
• suppression of tumor growth;
• destruction of viruses.

It is used to eliminate the inflammatory reaction that occurred due to a viral infection, for example, adenovirus, influenza. With the latter type of disease, the tissues of the eyeball are severely damaged, so injections are often indispensable.

Pheebs

Fibs is used due to inflammation of the eyelids, cornea, conjunctiva. Effectively eliminates inflammation and swelling. Helps to enhance the regeneration of damaged tissues.

Possible Complications

During the procedure, the following complications may develop:

• external and internal bleeding in the eye area;
• severe mechanical damage due to incorrect insertion of the needle;
• damage to the internal structures of the eyeball;
• decreased visual acuity;
• increased intraocular pressure;
• neuralgia;
• the appearance of temporary elements before the eyes (flies, dots, stripes, lightning).

Due to the increased risk of complications, self-injection of the eyeball is not recommended. Only a professional can do this.

Contraindications

Injections into the eyeball are contraindicated in the following conditions and diseases:

• an infection that is around the eyeball;
• acute viral and infectious diseases;
• exacerbation of a chronic disease;
• disruption of the kidneys or liver;
• individual intolerance to the active substance of the drug;
• pregnancy, lactation;
• underage age.

The contraindication may not be associated with the violation of the integrity of the eyeball itself, but with possible negative reactions to the action of the drug. Therefore, a preliminary diagnosis of the patient's condition is necessary using laboratory and instrumental research methods.

Retinal dystrophy is a very dangerous disease that affects the most important structure of the eye. The retina is responsible for our vision of objects. During the disease, photoreceptors are affected and tissues are destroyed, resulting in blindness.

Pathology in the early stages does not show its obvious symptoms, it occurs most often in older people. Dystrophy has a hereditary predisposition, so such people should definitely be diagnosed by an ophthalmologist.

Treatment is usually conservative, such as eye injections, especially the popular anti-VEGF. In this article we will talk about retinal dystrophy, its manifestations, diagnosis and the most popular drugs against the disease.

retinal dystrophy

The retina is one of the most important parts of the structure of the eye, which perceives light impulses. Retinal dystrophy is the general name for a group of diseases that affect the inner light-sensitive membrane of the eye.

During this process, vision suffers, the work of photoreceptors, which are responsible for the ability to see objects in the distance, and also to distinguish colors, deteriorates. Visibility is significantly reduced in dimly lit rooms.

The disease is considered very insidious, because in the first stages of the disease a person does not feel any symptoms. In modern medicine, there are many treatment methods that will help eliminate the signs of retinal dystrophy.

The retina is one of the most important components of the organ of vision. Thanks to the retina, the interaction of the perceiving (optical) parts of the eye with the visual areas of the brain is carried out.

Retinal dystrophy is a very broad concept that covers a large number of individual diseases that are independent or arise as a result of other diseases.

Retinal degeneration is one of the causes of deterioration or complete loss of vision. This disease is typical for people at a young age, and for the elderly. Retinal dystrophy may not manifest itself subjectively for a long time, but it leads to irreversible changes in the eye.

The thinnest layer of nervous tissue that lines the interior of the eye, at the back of the eyeball, is called the retina. It contains millions of light-sensitive cells called photoreceptors.

With their help, light stimuli turn into electrical ones. The transmission of electrical stimuli to the brain occurs with the help of nerve fibers of the optic nerve. There they are deciphered and turned into objective visual images that appear exactly as people see them.

The composition of this disease includes a group of various visual impairments, which are characterized by changes occurring in the retina of the eye. Currently, this disease is becoming the main cause of low vision and blindness.

With this disease, the visual function decreases slowly and steadily, with increasing progression. The disease can cause various vascular disorders, hypertension, diabetes mellitus.

The state of the retina during pregnancy is the main threat to vision. The main problems that may arise are considered: dystrophy, rupture or detachment of the retina.

With retinal dystrophy, treatment is carried out after a comprehensive examination of the patient. The pathology progresses slowly, rarely causing complete loss of vision. The disease is often confused with the macular form (due to a similar clinic), but the disease in question affects only the inner part of the organ.

Central retinal dystrophy is a severe disease of degenerative origin. This is an irreversible destruction of retinal tissue, during which visual acuity drops sharply. In this case, the macula may become thinner. The disease is considered the main cause of senile deterioration of vision.

Risk factors

Scientists note a hereditary predisposition to retinal dystrophy, so those who have a family history of retinal dystrophy (including macular and chorioretinal dystrophy of the retina) should be examined by an ophthalmologist as often as possible.

In addition, the risk group includes people with fair skin and blue color of the iris, with vascular diseases, diabetes, hypertension. Myopic patients are also more susceptible to retinal dystrophy than people with normal vision.

Statistics

According to statistics, men suffer from this pathology much more often than women.

Corneal dystrophy is a studied disease. Ophthalmologists identify special risk groups for the development of this pathology:

1. elderly people;
2. patients with myopia;
3. a history of vascular pathology;
4. patients with hypertension;
5. metabolic diseases.

Chorioretinal dystrophy of the retina is a hereditary disease that often develops in people with white skin and blue eyes. The fair sex is more susceptible to the disease. Retinal thinning is associated with vascular damage.

Often these changes are accompanied by:

• hypertension;
• ischemia;
• diabetes;
• trauma;
• intoxication;
• kidney damage;
• atherosclerosis;
• obesity;
• smoking;
• frequent uveitis.

The reasons

Dystrophic changes in the retina are most often caused by various vascular lesions.

Typically, vascular changes lead to:

1. hypertension and ischemic heart disease,
2. diabetes,
3. injury,
4. intoxication,
5. pathology of the kidneys and adrenal glands,
6. atherosclerosis,
7. overweight,
8. smoking,
9. old age,
10. myopia, uveitis.

Patients with myopia are most susceptible to the development of retinal dystrophy, since against the background of this disease, it becomes thinner in certain areas. Also, retinal dystrophy can develop in women during pregnancy. Hereditary forms of the disease are quite common.

Types of dystrophy

There are two types of retinal dystrophy:

• Congenital retinal dystrophy (caused by genetics). With this disease, irreversible changes occur in the retina.
• Acquired dystrophy often affects older people, at which senile changes occur in the retina.

Retinal dystrophy is divided into central and peripheral. With the central, damage occurs to the middle part of the retina, which is called the macula. At the same time, only the outlines of objects differ in patients, there is no difference between day and night.

Central dystrophy is divided into two forms: dry, in which metabolic products accumulate between the retina and choroid, and wet, in which fluid and blood accumulate in the retina.

Peripheral retinal dystrophy mainly affects nearsighted people. Sometimes its development occurs due to severe illnesses and due to severe complications of influenza, SARS, or various other infections.

Timely diagnosis of retinal dystrophy is very important, on which the effectiveness of treatment depends. Due to the asymptomatic course of the disease in the early stages, diagnosis is often not carried out in a timely manner, and is detected by chance, when visiting an ophthalmologist.

All retinal dystrophies are divided into hereditary and acquired, the latter are divided in turn into peripheral and central.

Hereditary dystrophies are pigmentary retinal dystrophy (with this pathology, the eye receptors responsible for vision at dusk suffer), cone-shaped progressive dystrophy dotted white (first appears in childhood), Best and Stargardt dystrophy, and many others. others

The acquired forms most often include those associated with aging, for example, chorioretinal dystrophy of the retina of the eye - it develops in older people over 60 years old, often detected along with cataracts.

Peripheral dystrophies are accompanied by degenerative changes in the periphery of the retina that do not affect the macular area, and are usually a complication of eye inflammation, eye injury, or myopia.

Under these conditions (and especially with myopia), a violation of the blood supply to the peripheral parts of the eye develops, because of which they receive less oxygen and nutrients, which leads to the development of dystrophic processes in the retina.

This type of retinal dystrophy is very difficult to diagnose, it is asymptomatic for a long time.

Central retinal dystrophy - degenerative changes that occur in the macular region (the place of the clearest vision). The most common diseases are macular age-related degeneration and serous central retinopathy.

In the central form of the disease, the macula is affected, retinal dystrophy leads to a significant deterioration in central vision with complete preservation of peripheral vision. Patients with this form of the disease lose the ability to read, write, and drive a car.

Illness during pregnancy

To prevent visual complications that may occur during pregnancy, it is imperative to conduct an examination of the vision of the expectant mother, during which, without fail, the condition of the retina is checked.

The examination is carried out at the 14th week of pregnancy, which is recommended by ophthalmologists. Diagnosis of the fundus, which has an enlarged pupil, is carried out. If no abnormalities are detected during the examination, a second visit to the ophthalmologist must be carried out by the 36th week of pregnancy.

If a pregnant woman has vision problems, then inevitably by the time of childbirth the question will arise about the method of delivery. The choice of delivery depends on many factors, such as: the state of the vision system and the retina, age, the presence of pregnancy pathologies, etc.

C-section

A caesarean section is a type of surgical operation in which the fetus is removed through an incision made in the anterior abdominal wall and uterus.

The operation poses a serious risk, many times higher than the risk that exists in natural childbirth. A caesarean section is performed strictly according to indications.

Severe toxicosis of pregnancy, arterial hypertension, increased swelling of the extremities is a sign of such a formidable condition as pregnancy nephropathy, which can also cause retinal detachment.

Symptoms

The clinical picture of retinal dystrophy varies greatly depending on the form of the disease. For example, the peripheral form is asymptomatic for a very long time and does not bother the patient.

The first symptoms of peripheral retinal dystrophy may appear when it detaches - black dots before the eyes, flashes of light. Chorioretinal and macular dystrophy of the retina are manifested by distortions of straight lines and loss of the central field of vision.

The dry form of macular degeneration is characterized by a gradual onset:

1. Difficulties arise when working with small objects, when reading small text,
2. vision deteriorates in the dark
3. environment is distorted
4. there are problems with face recognition.

Often, this symptomatology develops in only one eye, so the patient may not seek medical help for a long time. Wet macular degeneration is characterized by an acute onset of the disease with a rapid increase in the blind spot arising from the central zone, image distortion.

Diagnosis of retinal dystrophy

Diagnosis of retinal dystrophy includes the study of visual fields and color perception, visual acuity, examination of the fundus. To date, the most informative method of visualizing the retina is coherence optical tomography.

The main methods used to confirm the diagnosis:

• Perimetry and visometry.
• Examination of the fundus - with retinal dystrophy is difficult, requires good pupil dilation and examination with a three-mirror Goldman lens.
• Fluorescent angiography.
• Eye ultrasound.
• Electrophysiological examination of the eye (study of the functional state of the nerve cells of the retina, as well as the optic nerve).
• Laboratory tests (talking about the state of metabolism in the body as a whole).

The manifestations of the disease differ significantly, depending on the form of the syndrome. Some of its forms are asymptomatic. Peripheral syndrome manifests itself only with retinal detachment. Patients may have black dots and circles before the eyes, flashes of light.

Dry macular form develops gradually: people lose the ability to work with small objects, read small print. Vision is reduced in the dark, the environment is distorted, people find it difficult to recognize faces. The symptoms themselves may affect one or both eyes.

With a wet form, a sharp, rapid onset of the disease is noted. The blind spot of the central zone increases rapidly, the image of objects is strongly distorted. Lattice retinal dystrophy appears immediately. In this case, straight lines are deformed, the central fields of vision fall out.

To make a correct diagnosis, it is important to conduct a comprehensive examination of the patient. Often, corneal dystrophy requires examination and examination of visual fields. The most common, informative study is coherent optical tomography.

Treatment

Currently, methods of treating retinal dystrophy have not yet been invented. Therapy is selected by the doctor in accordance with the causes of the onset of the disease and the form of its course. Doctors often use laser coagulation to treat retinal detachment.

After this operation, the patient is prescribed to maintain a healthy lifestyle by quitting smoking and drinking alcohol. He should take vitamins, monitor his pressure and physical activity.

Medical treatment includes angioprotectors, vasodilators, corticosteroids, and a variety of other drugs. Under the conjunctiva, injections of flavinate and biogenic stimulants are made, various types of therapy are carried out.

To improve blood circulation and metabolic processes, a lot of necessary medical procedures are carried out, prescribed by an ophthalmologist.

People suffering from dystrophy wear dark glasses to prevent bright sunlight from entering their eyes. Their nutritious diet should be fairly balanced and include a variety of foods. Of great benefit are infusions prepared from various herbs that are useful for improving vision.

To achieve the best effect, an individual selection of a therapeutic technique is carried out, based on the stage and prevalence of the process. Unfortunately, it is impossible to restore visual acuity with the onset of retinal dystrophy.

In the initial stages of dystrophy, to delay the progress of the process, drug treatment is carried out: vasodilators, angioprotectors, retrobulbar corticosteroids, diuretics, biogenic stimulants, antioxidants, agents for expanding and strengthening the blood vessels of the eye, improving metabolic processes in the retina.

In addition, to slow down the processes of dystrophy, you can use photodynamic therapy, injections of special drugs aimed at inhibiting retinal dystrophy (anti-VEGF).

A special role is occupied by vitamins for vision with lutein, which protect the retina from excessive radiation, preventing the development of dystrophies, relieve eye fatigue associated with visual stress.

Visual impairment is often attributed to a lack of substances such as lutein and zeaxanthin. Moreover, with age, this deficit is felt more acutely. These substances are not produced in the intestines, so their content must be regularly replenished.

With complaints of a progressive decrease in vision, people after 45 years of age must follow a diet. In addition to zeaxanthin and lutein, the diet should include vitamin C, tocopherol, selenium and zinc, which nourish, repair and protect eye tissues.

In addition to following a diet, to prevent the development of age-related changes in the retina, it is necessary to take multivitamins. It has been proven that such a composition prevents the development of age-related changes in the retina of the eye, and allows even the elderly to enjoy sharp vision.

To date, there are no effective methods for treating the dry form of macular degeneration of the retina, so its prevention is such an important aspect.

For the treatment of the wet form, intraocular administration of the preparations Aileya and Lucentis is used, which inhibit the growth of new vessels, eliminate retinal edema. The course of treatment can take about two years, during which time 3-8 injections are made.

Physiotherapeutic methods of treatment are also used, although they do not have a significant effect on stopping the process of dystrophy and restoring vision - phono- and electrophoresis, ultrasound, microwave therapy and laser intravenous blood irradiation.

An example of a device that can be used at home is "Sidorenko Glasses" - combining 4 methods of exposure at once, including pneumomassage. All this makes it the most effective eye device available today. The low price is also an advantage.

Method of treatment

To improve blood circulation and metabolism, vasoreconstructive operations are used: ligation of a branch of the surfaces of the temporal artery, as well as operations on varicose veins for revascularization of the posterior pole of the eye (rarely used).

For the treatment of wet forms of central retinal dystrophy, operations are performed to prevent the accumulation of fluid in the retina.

The most effective method of treatment is laser coagulation - it prevents the development of a serious complication of dystrophies - retinal detachment. This method of treating dystrophy, including the treatment of macular retinal dystrophy, as laser coagulation, is used in all major ophthalmological clinics and centers of vision.

During this procedure, cauterization of the retina occurs in the most critical areas, which leads to its strengthening and is an excellent measure to prevent retinal detachment. The operation is absolutely bloodless, well tolerated even by debilitated and elderly patients, children up to the neonatal period.

Unfortunately, all types of therapeutic effects in retinal dystrophy are aimed not at curing, but at preventing the progression of the process.

It will no longer be possible to restore visual acuity to normal with retinal dystrophy, so the task of the ophthalmologist is to identify the disease in the early stages and timely prescribe treatment that will stop the dystrophy process.

Therefore, it does not matter what form of the disease the patient has - hereditary or acquired, chorioretinal or macular degeneration of the retina, the treatment is aimed only at blocking the further progression of the pathology.

When choosing a clinic for the treatment of retinal dystrophy, choose an institution where you can undergo a complete diagnosis and all types of treatment using modern equipment. When choosing a medical institution, it is important to consider not only the cost of treatment, but also the level of specialists and the reputation of the clinic.

Fighting the disease with injections in the eyes

Modern treatment of retinal dystrophy can be successful. To achieve the maximum effect, it is important to carry out an individual selection of therapy. It all depends on the patient's condition, stage and prevalence of the pathological process.

Initial changes can be cured or slowed down with medication. The medical complex often includes:

1. vasoconstrictor drugs;
2. angioprotectors;
3. corticosteroids retrobulbarno;
4. diuretic agent.

You can take medications to expand and strengthen blood vessels, improve retinal metabolism. For these purposes, Taufon, Emoksipin is prescribed. Photodynamic therapy is used to combat the disease and slow its progression.

They make injections in the eyes with retinal dystrophy. For this, anti-VEGF is used. They are aimed at suppressing pathological changes. The course of such therapy is up to 10 injections. Each injection significantly improves the patient's condition.

For treatment, you can use vitamins with lutein. They are specially designed to protect the retina from harmful effects: radiation, chemicals, dust. In this way, degeneration is inhibited, eye fatigue from visual stress is minimized.

To prevent the occurrence of age-related changes in the retina, you can take multivitamins. The vitamin-mineral complex Okuwait Luten Forte has proven itself well.

Due to its balanced composition, it can be used to protect the eyes from harmful sunlight. This drug has been proven to be an excellent home treatment for people of all ages.

Retinal disease often provokes the middle and high stages of myopia. This is affected by the force of the eyeball enlargement, in which the retina is stretched and deformed.

Depending on the degree and causes of retinal dystrophy, the doctor prescribes medication. Eye injections are considered effective with Ailiya and Lucentis medicines, which eliminate puffiness. They are most effective in the dry form of dystrophy. The course of treatment lasts about 2 years, injections are made from 5 to 8 times.

Medication is prescribed to the patient only at an early stage of the disease or after surgery. Such therapy can improve visual acuity, accelerate the healing process, restore the affected areas of the eyes.

Most often used: Papaverine and Askorutin, which are considered angioprotectors. Such drugs tighten the vascular system. Bady, for example, Enkad. Vitamin supplements: Blueberry-Forte, Lutein. Pentoxifylline improves and stimulates blood circulation.

Eye drops and their effects

Eye drops cope well with the symptoms of retinal dystrophy. The doctor prescribes them as a prophylaxis of the disease, as well as in the postoperative period. They also serve as an antibacterial agent. Most often, drugs such as Taurine and Emoxipin are recommended.

Both drugs produce the same effect, but Emoxipin causes some discomfort, in the form of burning and pain in the eyes. Doctors do not recommend it for people with hypersensitivity and allergic reactions.

In any case, you need to consult a doctor who, after examination, will prescribe the necessary drug, depending on the stage of the disease and the individual characteristics of the body.

The use of drops will improve the condition of the retina, improve the process of blood supply and remove small hemorrhages. With dry dystrophy, drops moisturize the retina well, forming artificial tearing.

In addition to these drugs, there are many others that can be prescribed for therapeutic and prophylactic purposes. Among them, the leading position is occupied by Timolol, which is able to additionally affect the vascular system. For the best effect, eye drops are used in combination with other methods of therapy.

Other Therapies

Failure of visual function can be associated with a lack of zeaxanthin. With age, this deficiency only increases, provoking retinal depletion. The substance is not synthesized in the body, so its content is important to constantly replenish.

The elements of the organs of vision can become thinner due to unhealthy food, overeating, so all people after 45 years old can and should follow dietary recommendations. A similar condition is observed with a deficiency of vitamins and minerals. The diet should include a sufficient concentration of vitamin C, tocopherol, selenium, zinc.

These components nourish, restore and protect the organs of vision from harmful influences. Macular degeneration of the retina, its dry form, is a difficult pathology that cannot be overcome.

Wet Syndrome Treatment

Wet syndrome can be treated. For this, intraocular (intraocular) administration of drugs is successfully used. Often use Ilia, Lucentis.

With damage to the retina, therapy with such drugs inhibits the growth of new vessels, minimizes swelling of the eye. With pathologies of the retina, treatment can last up to 2 years, during which time up to 8 injections are administered.

Physiotherapy is considered an important component of the complex treatment of PCRD, although this technique has no proven effect to stop the process. Use:

• phonophoresis;
• laser parenteral blood irradiation.

Dystrophic diseases can be treated at home with the Sidorenko Points device. This is a device for complex effects on the human eye. Combines 4 methods of influence at the same time. Because of this, it is called the most effective eye treatment device.

This device has many advantages, including:

1. portability;
2. complex influence.

With PVRD, vasoreconstructive interventions can be used to improve blood flow. Usually ligate the branches of the artery, operate on varicose veins. To combat the wet forms of the disease, interventions are shown that prevent the accumulation of fluid.

Peripheral chorioretinal dystrophy is successfully treated with coagulation. The technique prevents serious complications of the disease. This is the most common method of struggle, the essence of which is cauterization of the retina in critical areas of one or both eyes.

The technique strengthens the organs of vision and prevents complications. The intervention is absolutely bloodless, well tolerated by patients. Therefore, it became possible to treat retinal diseases at any age.

Therapeutic interventions can only stop degenerative-dystrophic changes. The main task of the doctor is the early detection and timely treatment of the disease. Therefore, even peripheral vitreochorioretinal dystrophy requires adequate medical intervention.

Therapy should be carried out by specialized specialists - treatment with folk remedies is unacceptable. When choosing a clinic and a doctor, it is important to take into account the usefulness of the examination, modern equipment, and the competence of doctors.

Intravitreal drug injections - Anti-VEGF therapy

In order for drugs that counteract the development of new vessels to effectively affect the macula, it is necessary to inject directly into the vitreous body of the eye. The procedure is performed in a sterile operating room by a qualified ophthalmologist.

The procedure for administering the drug takes only a few minutes and does not cause any pain. As the anti-VEGF drug penetrates the macular tissue, it reduces the activity of the protein, resulting in the growth of abnormal blood vessels, after which these vessels begin to disintegrate.

The control of angiogenesis and associated edema stabilizes visual function and prevents further damage to the macula. Approximately 30% of patients receiving anti-VEGF therapy for wet AMD recover some of the vision lost due to this disease.

Drugs for the treatment of age-related macular degeneration - Lucentis (Lucentis) and Eylea (Eylea) The first drug for anti-VEGF therapy in the form of intravitreal injections, certified in Russia for use in ophthalmology, was Lucentis.

In June 2006, it was approved by the US Drug Control Agency (FDA) as a unique drug for the treatment of age-related macular degeneration, and in 2008 it was registered in Russia.

Scientists continued their research to create a drug with a more prolonged action, not inferior in terms of quality results to LUCENTIS. In November 2011, EILEA was approved for the treatment of wet age-related macular degeneration in the United States.

Since March 2016, the drug has been registered in Russia and has been used in Excimer ophthalmological clinics. Why are LUCENTIS AND EILEA effective? Prior to the advent of these drugs, anti-VEGF therapy used drugs created for the treatment of cancer.

LUCENTIS (and later EILEA) were specially developed for ophthalmic use, which ensures their higher efficiency and safety.

The composition of the drug LUCENTIS includes molecules of the active substance - ranibizumab, which reduces excessive stimulation of angiogenesis (growth of pathological vessels) in age-related macular degeneration and normalizes the thickness of the retina.

The action of the drug

LUCENTIS quickly and completely penetrates into all layers of the retina, reduces macular edema and prevents the increase in the size of the lesion, the progression of the formation and germination of blood vessels and new hemorrhages.

EILEA is a preparation containing the active substance - aflibercept, whose molecules act as a "trap", splicing with molecules not only of vascular endothelial growth factor (VEGF), but also of placental growth factor (PIFG).

In addition, this drug can be used not only in the "wet" form of age-related macular degeneration, but also in cases of visual impairment caused by diabetic macular edema and macular edema due to retinal vein occlusion.

What do scientific studies show?

The clinical activity and safety of drugs have been proven in a number of large international trials. The results are truly impressive - in most patients, not only did the progression of the disease stop and visual acuity was preserved, but this indicator improved significantly.

The thickness of the central zone of the retina before and after treatment In comparison with laser treatment (photodynamic therapy), anti-VEGF drugs significantly exceeded the results in terms of visual acuity: by 6 months of treatment, injection therapy gave ~ 8.5-11.4 letters (according to the ETDRS scale ), while in the laser treatment group - 2.5 letters.

By week 52, the anti-VEGF groups gained 9.7-13.1 letters, while the laser treatment group lost 1 letter. After 52 weeks of treatment, the proportions of patients who maintained visual acuity in the groups treated with LUCENTIS and EILEA were 94.4% and 95.3%, respectively.

Statistics

The proportion of patients with an increase in visual acuity of ≥15 letters on the ETDRS scale - with EILEA - 30.6%, with LUCENTIS - 30.9%, and the average value of improvement in visual acuity - 7.9 letters and 8.1 letters in the treatment of EILEA and LUCENTIS.

The interval between doses is at least 1 month. After the onset of the stabilization phase, treatment with the drug is suspended, but 2-3 times a year, patients need to undergo screening of the state of the visual system.

Treatment with EILEA begins with three consecutive injections into the vitreous body at a dose of 2 mg, then one injection is performed after 2 months, with no additional follow-up examinations between injections.

After reaching the "stabilization" phase, the interval between injections may be increased by the attending physician based on the results of changes in visual acuity and anatomical parameters.

cortisone injections

A feature of wet macular degeneration is a pronounced inflammatory process, in which abundant exudation and weakness of the walls of newly formed vessels often cause hemorrhages and the development of glaucoma.

Therefore, one of the rational methods of therapy is the introduction of cortisone, an anti-inflammatory steroid drug, into the eyeball. It effectively eliminates exudation and contributes to the normalization of vision.

The cortisone injection procedure should be repeated at least once every three months for two years. Implantation of an intraocular lens The development of macular degeneration is also influenced by ultraviolet radiation.

It is possible to eliminate the influence of this spectrum of sunlight by installing an intraocular lens. The operation is performed using a laser - the lens is replaced with an artificial element.

Within a few hours, the patient can go home. The lenses are completely invisible and reliably stop the progression of age-related dystrophy.

Traditional medicine recipes, how to restore vision?

In ophthalmology, there are several ways to administer drugs. Most often, drugs are applied topically - instillation into the conjunctival sac or laying ointments.

Features of the composition of eye drops

Eye drops, ointments, sprays, films, gels are medicines that are specially designed for topical use in ophthalmology. In addition to the active component that has a therapeutic effect, their composition includes excipients necessary to create a stable dosage form. In order to prevent contamination of the drug with microbial flora, it also contains preservatives. They can affect the conjunctiva and to varying degrees. For patients with sensitive corneas, there are local forms of ophthalmic preparations that do not contain preservatives.

In order to prevent the breakdown of the active ingredient, eye drops also include antioxidants.

The ability of eye drops to penetrate the cornea of ​​the eye depends on their ionization. This indicator is determined by the pH of the solution. Normal acidity is 7.14-7.82. The acidity of the solution affects both the pharmacokinetics of the drug and its tolerability. If the acidity of the solution differs significantly from that of the lacrimal fluid, a person will feel discomfort when instilled.

An important indicator of the kinetics of the drug is its tonicity in relation to the tear. Hypotonic or isotonic solutions have the greatest absorption. Thus, the effectiveness of the drug is determined not only by the active ingredient, but also by the incoming excipients.

Many eye drops cannot be used while wearing soft ones. This is due to the risk of accumulation in their material of both the main substance and preservatives. The patient should be aware that before instillation of eye drops, lenses should be removed and put on only 20-30 minutes after instillation of the drug. When prescribing more than one drug, the period between instillation should be at least half an hour.

Basic rules for instillation of eye drops

• Wash your hands thoroughly before instilling the drug.
• The head must be tilted back.
• Look up, pull the bottom down.
• Drop one drop of the drug into the conjunctival sac.
• Look up until the drop of the drug is completely distributed in the conjunctival sac.
• Release your eyelid, close your eyes.
• In the area of ​​\u200b\u200bthe inner corner of the eye, press with your index finger for 2-3 minutes.
• If you need to use several types of eye drops, repeat the procedure after at least 20 minutes.

Rules for laying eye ointment

• Tilt your head back.
• Pull the lower eyelid down, look up.
• Squeeze a strip of eye ointment about 1 cm long into the fornix of the conjunctiva.
• Lower your eyelid slowly, close your eyes.
• Using a cotton swab or cotton swab, massage the ointment through the eyelid.
• Leave your eyes closed for 1-2 minutes.
• You can repeat the procedure if you need to use another ointment or drops after 20 minutes.

Rules for laying the eye film

• Wash your hands thoroughly before the procedure.
• Tilt the patient's head back.
• Ask the patient to look up, pull the lower eyelid down.
• Using tweezers, insert the ophthalmic drug film into the lower part of the conjunctival sac.
• Lower your eyelid slowly.
• Ask the patient to sit with their eyes closed for 5 minutes.
• It is possible to use other drugs only after the complete dissolution of the film.

Frequency of use of ophthalmic dosage forms

The frequency of use of drugs for the treatment of eyes may vary depending on the pathology and pharmacokinetics of the drug. In the case of acute infectious lesions of the eyes, the frequency of instillations can reach up to 10-12 times a day; in chronic diseases, eye drops can be used 2-3 times a day.

Eye ointment is usually applied up to two times a day. Eye ointments are not recommended for use in the early postoperative period after abdominal interventions, as well as for penetrating eye injuries.

In some cases, in order to increase the amount of the drug entering the eye, the method of forced instillations is used: the drug is instilled 6 times within an hour every 10 minutes. The effectiveness of this method corresponds to subconjunctival injection.

To increase the penetration of the drug, laying a cotton swab soaked in the drug can also be used in the conjunctival sac.

Rules for laying cotton wool soaked in a drug

• Wash your hands thoroughly before handling.
• Roll a piece of cotton wool in the form of a tourniquet and soak with the preparation.
• Ask the patient to tilt their head back.
• Pull back the lower eyelid.
• Insert a cotton swab with tweezers into the outer section of the lower fornix of the conjunctiva.
• Lower your eyelid slowly.
• Ask the patient to keep their eyes closed for 5 minutes.
• The cotton can be removed after 30 minutes.

Additional methods of drug administration

Additional routes of drug administration in ophthalmology include periocular injections: subconjunctival, parabulbar, retrobulbar.

Rules for performing a subconjunctival injection

• Treat your hands before manipulation.
• Instill 1 drop of anesthetic into the patient's eye.
• You can perform the injection after 4-5 minutes.
• Depending on the injection site, ask the patient to look up or down, pull back the lower or upper eyelid.
• Puncture the conjunctiva in the desired area, while the needle should be directed towards the conjunctiva. Enter 0.5-1 ml of the drug under the conjunctiva.
• Lower your eyelid slowly.

Rules for performing parabulbar injection (method 1)

• Treat your hands.
• Feel the inferior-outer edge of the orbit. Insert the needle parallel to the lower wall of the orbit to a depth of 1-2 cm. The cut of the needle should be directed towards the eyeball. Do not use needles that are too thin and sharp (for example, insulin) to perform the procedure.
• Enter 1-2 ml of the solution.
• Remove the needle.
• Press the injection site with a cotton swab and hold for 1-2 minutes.

Rules for performing parabulbar injection (method 2)

• Treat your hands.
• Administer anesthesia (use eye drops with an anesthetic). The procedure can be performed after 4-5 minutes.
• Ask the patient to look up and towards the nose.
• Pull back the lower eyelid.
• Puncture the conjunctiva, insert the needle at an angle of 25°, advance 2-3 mm, with the cut of the needle directed towards the eyeball.
• Enter 0.5-1 ml of the drug into the sub-Tenon's space.
• Remove the needle.
• Release your eyelid.

Rules for performing a retrobulbar injection

The rules for conducting a retrobulbar injection are the same as for a parabulbar one, but the needle is inserted to a depth of 3-3.5 centimeters. First, you need to navigate parallel to the wall of the orbit, then - obliquely upwards. The plunger of the syringe must be pulled towards you before the injection of the drug, in order to make sure that the needle is not in the blood vessel.

Paracentesis

In some cases, the drug is injected directly into the cavity of the eye (or into the anterior chamber). This procedure is carried out in the operating room, can be performed as an independent intervention or during the operation.

Lucentis (ranibizumab) is a drug whose primary use is intravitreal administration for anti-vasoproliferative purposes. Intravitreal injection is one of the most effective therapeutic methods in modern ophthalmic practice. In this way, drugs can directly reach the target of their influence - the retina for the treatment of various severe pathologies of the fundus. A certified drug for intravitreal administration is Lucentis, which will be discussed in this article.

What is Lucentis

The active substance of Lucentis is ranibizumab, which, from a biochemical point of view, is a fragment of a human recombinant monoclonal antibody intended for intraocular administration. Many pathological conditions of the fundus, including the wet form of macular degeneration and diabetic retinopathy, are accompanied by the growth of newly formed blood vessels that are abnormal in structure and functional properties. Such vessels are defective, prone to frequent ruptures, which is accompanied by hemorrhages in the retina, vitreous body and subretinal space.

Such a pathological process is, in fact, endless and leads to irreversible loss of vision. A special group of drugs, anti-vasoproliferative agents, helps to stop the proliferation of pathological blood vessels. This group includes ranibizumab or Lucentis. The Lucentis injection binds and thereby blocks the biological activity of human vascular endothelial growth factor (VEGF), which prevents the growth of blood vessels.

Composition and dosage form of Lucentis

Lucentis is a sterile, colorless or pale yellow, slightly opalescent solution in a manufacturer-filled disposable syringe or disposable glass vial. The sterile solution contains 10 mg/ml ranibizumab. The excipients contained in the solution are histidine, polysorbate, trehalose dihydrate. The volume of the solution in the vial is 2.3 ml. A vial of the drug cannot be used for several patients; therefore, one injection of Lucentis is designed for only one intravitreal injection. The manufacturer of Lucentis is Novartis Pharma (Switzerland). It is necessary to store the drug in the refrigerator observing the temperature regime - 2-8 ° C. Freezing the drug is prohibited. It is necessary to store in a place protected from light. Violation of storage or transportation conditions may affect the medicinal properties of the drug.

Mechanism of action of Lucentis

Lucentis (Ranibizumab) is an antibody fragment against vascular endothelial growth factor A (VEGF-A). It is VEGF-A that has been shown to cause neovascularization and fluid shedding through the vascular wall, processes that underlie the progression of wet macular degeneration and other retinal diseases. The use of Lucentis leads to the binding of VEGF-A, thereby preventing the interaction of the molecules of this substance with the receptors of the same name (VEGFR1 and VEGFR2). The described receptors are localized on the surface of endothelial cells lining the inner wall of capillaries. The injection of Lucentis leads to a reduction in endothelial proliferation, a decrease in the leakage of fluid through the vascular wall and the formation of a much smaller number of new functionally defective blood vessels.

Based on pharmacokinetic analysis, the vitreous half-life of ranibizumab after injection of Lucentis at the standard 0.5 mg dose is approximately 9 days. The plasma concentration of the drug decreases in proportion to its elimination from the cavity of the eyeball. It should be noted that the concentration of ranibizumab in plasma is 90,000 times less than its concentration in the cavity of the eyeball. This means that the drug does not actually have a systemic effect.

Indications for use of Lucentis

The instructions for the use of Lucentis, as well as the data of many scientific studies, define the following indications for the intravitreal administration of this drug:

• Neovascular (wet) form of macular degeneration.
• Macular edema, resulting from occlusion of the retinal vein.
• Diabetic retinopathy with macular edema.
• Choroidal neovascularization caused by myopia.

This list of indications is general. The need for intravitreal administration of Lucentis is determined by the attending physician for each individual patient based on the clinical picture, as well as the dynamics of the state of the fundus.

Frequency and Dosage of Lucentis

Lucentis is for intravitreal administration only. The frequency of administration and dosing regimen depends on the type of pathology of the fundus:

• In neovascular (wet) form of macular degeneration 0.5 mg (0.05 ml of a 10 mg / ml solution) Lucentis injection is recommended to be performed with an interval of 1 intravitreal administration of the drug once a month (the minimum interval between injections is 28 days). During treatment, periodic examination of the fundus and control of visual acuity is necessary. It is acceptable to slow down the administration of the drug after 3 consecutive injections, provided that the condition stabilizes and visual acuity improves. It is acceptable that the injection of Lucentis is performed 1 time in 3 months after consecutive 4-fold use of the drug.
• The basic dosing regimen for macular edema resulting from blockade of the retinal vein, as well as for diabetic retinal pathology, is similar - 0.5 mg (0.05 ml of a 10 mg / ml solution) of Lucentis is recommended for intravitreal administration once a month. A monthly injection of Lucentis should alternate with monitoring the condition of the fundus and visual acuity.
• Myopia-induced choroidal neovascularization requires intravitreal administration of 0.5 mg of Lucentis every month for three months. According to the indications, the course of treatment can be repeated.

Control of the dynamics of the disease is carried out by assessing visual acuity, as well as by conducting fluorescein angiography and optical coherence tomography. In the neovascular form of macular degeneration, as well as in the case of choroidal neovascularization associated with pathological myopia, the absence of negative dynamics in visual acuity and the state of the retina is considered a measure of the effectiveness of therapy. If there is no effect from several injections of Lucentis, the doctor has the right to cancel therapy without waiting for the end of the course of treatment. The use of Lucentis can be combined with laser photocoagulation of the retina.

Intravitreal injection of Lucentis

Intravitreal injection of Lucentis is an eyeball surgery and therefore must be performed in a sterile operating room. The optimal prevention of postoperative infectious complications is the observance of all asepsis rules, as well as the treatment of the surgical field with an iodine-containing antiseptic, in the absence of an allergic reaction to iodine. Before manipulation, the doctor conducts an examination of the eye fundus and measurement of intraocular pressure. The thickness of the needle for the intravitreal injection of Lucentis is 27-30G. The injection site is located 3.5-4 mm from the limbus, in the so-called pars plana, so as not to touch the retina and lens. After passing the needle into the cavity of the eyeball, a gradual intravitreal introduction of Lucentis into the vitreous body is performed. The Lucentis injection is practically painless, so local anesthesia in the form of eye drops or anesthetic gel is sufficient.

Control of intraocular pressure should be carried out within 30 minutes after intravitreal administration of Lucentis. Also, a specialist must control perfusion in the retinal artery. 3-7 days after the manipulation, an ophthalmological examination is necessary to monitor the condition of the fundus and early detection of infectious complications. Prophylactic administration of an antibiotic after intravitreal application of Lucentis is at the discretion of the attending physician.

Contraindications for the administration of Lucentis

Contraindications to the use of the described drug are determined not only by the properties of the drug itself, but also by the method of its use. There are situations when the intravitreal administration of Lucentis itself is contraindicated for this or that patient. The use of Lucentis is contraindicated in the following clinical situations:

• Individual intolerance or hypersensitivity to ranibizumab, previously occurring allergic reactions to the administration of this drug.
• Proven infectious and inflammatory processes of the eyeball and periocular region.
• Pregnancy and lactation are also contraindications to the use of Lucentis.
• The age of the patient is under 18 years, since scientific studies on the use of Lucentis in pediatric patients have not been conducted.

Both indications and contraindications for intravitreal administration of Lucents are determined by the attending physician individually for each patient.

Lucentis analogs

The group of antiproliferative agents is represented not only by Lucentis. There are other drugs with a similar mechanism of action. Let's consider some of them:

• Avastin. The active substance of this drug is bevacizumab, which is similar in mechanism of action to ranibizumab or Lucentis. Avastin has been actively used for the purpose of chemotherapeutic treatment of oncological diseases. Later, scientific studies were carried out and the effectiveness of Avastin as an antiproliferative agent was proven. Bevacizumab is used to treat diabetic retinopathy, choroidal neovascularization, and neovascular macular degeneration.
• Eylea. The active substance of this drug is aflibercept. This tool was approved for the treatment of fundus pathology in 2011. Indications for use are similar to those of Lucentis. A feature of this tool is its ability to bind not only endothelial vascular growth factor, but also placental growth factor. A feature of this drug is a longer time of action.

The choice of a drug from the group of anti-vasoproliferative agents always remains with the attending physician. The patient is always informed in detail about all the features, on the basis of the information received, he agrees to the intravitreal administration of Lucentis or any other of its analogues.

Lucentis. Price and cost of treatment

The price of treatment with Lucentis includes not only the cost of the drug, but also the intravitreal injection procedure itself. This procedure, despite its apparent simplicity, is no less responsible manipulation than other types of interventions in ophthalmology. There is a risk of developing infectious complications after the introduction of the drug into the cavity of the eyeball. Therefore, such manipulation should be carried out only by a highly qualified specialist under sterile conditions. The need for intravitreal injection of Lucentis in a specialized operating room, as well as the use of a large number of consumables, determines the cost of using Lucentis. The price of the drug Lucentis in the retail pharmacy chain in Russia is 50,000-52,000 rubles. The cost of intravitreal administration of the drug ranges from 18,000-25,000 rubles. It is also necessary to remember about the control visits to the ophthalmologist during the treatment process, as well as about the diagnostic manipulations prescribed by the doctor.

Lucentis is one of the modern and safe anti-vasoproliferative agents, the use of which successfully helps to stop the progression of such formidable ophthalmic diseases as diabetic retinopathy and neovascular (wet) form of macular degeneration. The use of Lucentis has a large number of positive reviews both among patients with retinal pathology and among practicing ophthalmologists. Its use has helped maintain and improve the vision of a huge number of patients. And if you have previously had an injection of Lucentis, we will be grateful if you leave your feedback about the drug on our website on the page

Known methods of correction and treatment of eye diseases are laser therapy and drops. Ophthalmologists call another procedure - intravitreal injection. Different methods of injecting drugs into the eye help to quickly achieve a therapeutic effect, especially in cases where drops are not effective. The procedure requires precision and care, so it should be done by an experienced ophthalmologist.

In what cases do

Injections into the eyes are used for damage to the deep layers of the eyeball.

Indications:

• inflammation of the eyes - conjunctivitis, uveitis, iridocyclitis;
• blood clots in the veins of the retina;
• excessive proliferation of blood vessels;
• age-related retinal degeneration;
• retinal detachment;
• glaucoma;
• eye injury;
• autoimmune diseases - endocrine ophthalmopathy, rheumatoid arthritis;
• diabetic edema;
• intraocular hemorrhages.

Injection treatment can prevent or delay the development of age-related changes in the retina. Depending on the disease, the doctor chooses the method of administering the drug. From the injection, the therapeutic effect lasts longer.

How injections are given

The eye injection is painful. Before giving an injection, a drug that dilates the pupil is instilled into the eyes. Then the eye is anesthetized with novocaine or dicaine, also in drops. Five minutes later, the injection begins.

Types of eye injections

Types of injections differ in the localization of injection into the eyeball:

1. Subconjunctival- the medicine is delivered under the mucous membrane of the conjunctiva through a needle with a diameter of 0.3 mm or less;
2. Parabulbar - into the lipid layer between the periosteum and sclera through the lower eyelid, the needle of an insulin syringe is inserted parallel to the lower part of the orbit;
3. retrobulbar- the needle penetrates into the lower eyelid parallel to the wall of the orbit and penetrates into the edge of the orbit, the method delivers the medicine behind the eyeball;
4. intravitreal- directly into the vitreous body;
5. Intra-arterial- retrograde into the ophthalmic artery;
6. Subchoroidal- by uveoscleral route.

The eye socket has the shape of a pyramid, with its apex facing inside the skull. In the wide part of the pyramid is the eyeball, surrounded by a fatty layer. A parabulbar injection is made in the area between the eye and the bone base of the pyramid - the periosteum.

A subconjunctival eye prick is also called a subconjunctival eye prick. Before the injection, the eye must be anesthetized three times with a minute interval. A slice of the insulin syringe is directed towards the eye.

Intravitreal injection is a definition meaning an injection directly into the eye. It is used to prevent disordered vascular development and treat age-related macular degeneration.

Before subconjunctival, parabulbar and retrobulbar eye injection, the needle insertion site is disinfected with ethanol. After removing the needle, the puncture is closed with cotton wool with an antibacterial agent. The action of drugs is sometimes enhanced by the addition of lidase or adrenaline.

Some ophthalmologists practice the introduction of emoxipin into the temple for more effective treatment of glaucoma.

Preparations for injections in the eyes

After a comprehensive diagnosis, the ophthalmologist prescribes the medicine according to indications. Anti-VEGF drugs prevent the growth of eye vessels in retinal dystrophy. According to the mode of action, drugs are distinguished:

• Corticosteroids - Ozurdex, Kenalog;
• Angioprotectors - Avastin, Euler, Lucentis;
• Firming - Fibs, Emoksipin, Retinalamin;
• Anti-inflammatory - Reaferon.

Intravitreal injection of cortisone helps to eliminate the weakness of the vessels of the eyeball and hemorrhage in macular degeneration. The steroid drug is administered once every three months for two years.

Contraindications and complications

Eye medicines have side effects and contraindications.

The basis of the drug Avastin Bevacizumab causes individual intolerance, is contraindicated in pregnant women and breastfeeding. Avastin is not recommended for use in hepatic and renal insufficiency.

Reaferon is contraindicated in diseases of the liver, heart and kidneys, as well as the central nervous system. It can not be used for epilepsy, interferon intolerance, pregnancy and lactation.

Immunomodulatory Interferon Alpha-2 as part of the drug is not combined with immunosuppressants and sedatives. Contraindications to its use are mental disorders.

Emoxipin should not be mixed with other drugs. With combined treatment, it is used 20 minutes after the introduction of other drugs. Emoxipin also causes allergies and individual sensitivity.

Complications arising after the procedure:

• swelling of the conjunctiva, eyelids;
• irritation of the sclera;
• lens damage;
• increase in intraocular pressure.

Negative reactions after an eye injection are associated with a lack of practice, the negligence of the doctor who gave the injection. Violation of the technology of the procedure, non-sterility, unsuitable conditions lead to eye damage. If the puffiness is caused by a reaction to a drug or tissue puncture, a cold compress will relieve an unpleasant symptom.

How is rehabilitation after manipulation

Treatment of eye pathologies lasts more than two years. The course may consist of 8-10 injections. The frequency depends on the disease and the doctor's prescription. The interval between injections is at least a month. With the onset of a stable phase, the doctor increases the interval.

In the period between injections, strengthening and antibacterial drops are prescribed. With dystrophic changes in the retina, it is necessary to take multivitamins and follow a diet. Lutein, vitamin C, zinc, selenium are useful for eye health.

For the health of the retina, it is important to replenish the deficiency of the substance zeaxanthin.