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Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 11414
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I have a good friend who has been receiving shots of

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I have a good friend who has been receiving shots of Lucentis for macular degeneration for 4 1/2 years. She was not happy with quality of care, changed Dr. and did ok with the first shot. For the second one she had told them she is allergic to betadine which they used and the Dr. injected her eye 4 times at angles to keep the numbing agent shallow and then gave her the Lucentis. She had so much pain, she went back the next day, they put a numbing agent on her eye and a contact to cover. The pain increased, her eyesight was much worse than before the shot and they put on a clean contact again. It has now been 13 days sense the shot, 10 of those days spent in great pain which she had not had before and she still does not have the eyesight she had before the shot. Do you have recommendations for her as she only has this eye, the other eye has no central vision. Thank you.
Hi. I'm online and happy to answer your question today.
I am a retina specialist.
It sound like she may have a corneal abrasion that is refusing to heal.
You said she has had pain for the last 10 out of 13 days....does that mean that her eye no longer hurts?
Is your question concerning her decreased vision or the episode of pain, or both?
This is not an answer, but an Information Request. I need this information to answer your question. Please reply, so I can answer your question. I look forward to helping you.
Customer: replied 4 years ago.

Her eye no longer hurts, vision is better but not as good as before the shot. Her upset is after having had 40-50 shots she has never had this severe reaction. The dr. did tell her that she have a large corneal abrasion afterwards but could not answer why. She had told them not to use the betadine and they did, he was quick to answer they washed the betadine out right away, but if that is the problem they must not have gotten it out of her eye. She is very aprhensive about having another shot, she hadn't been before, she cannot afford to lose her eyesight as her other eye is legally blind. Do you have suggestions or ideas for her? Thank you.

I agree that the pain was from a corneal abrasion. While it unusual for the diluted betadine to cause an abrasion, it could have been due to her allergic reaction or, possibly (and most likely) from trauma when the technician rushed to get the betadine out of her eye.
In any event, to answer your question: What to do now in order to preserve her vision and, hopefully, get her vision back to the level it was before this all happened.....
If lucentis has been working for her all this time, then I suggest she continue with the lucentis shots. There are two other shots available to treat her condition (sub-foveal choroidal neovascular membrane secondary to wet age related macular degeneration) at this time. They are called avastin and afibercept.
Should the lucentis stop working then I would try either of the other two...but...I'd not switch drugs just because of this painful episode.
The only other option (I don't believe in submacular surgery...yet) is to have a laser treatment, like we did before these shots were available. Laser will cause her to loose vision right away, but in the long run her central blind spot would be smaller....
So. What is the take home message? Make sure her doctor uses a different method of preventing infection when giving the lucentis shot (such as antibiotic drops etc) and she should continue with the lucentis.
This is what I would do if she were a patient in my retina office.
Is there anything else you would like to discuss at this point or have all your questions been answered to your satisfaction?
I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations.
Thanks in advance,
Dr. Rick MD FACS
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Customer: replied 4 years ago.

Thank you for your help, I am calling her and giving her your information as it comes to me. She has to decide if she will continue with the same dr. but does appreciate your input.

My pleasure.
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