Eye injections are the only medication currently available to treat diabetes-related retinopathy. Modern eye injections are not painful and don’t cause many side effects.

Diabetic retinopathy affects more than 1 in 3 people with diabetes and accounts for much of the vision loss that occurs in people with diabetes.

When your diabetic retinopathy progresses to the treatment stage, you may need medicated eye injections to help prevent this diabetes complication from getting worse and leading to vision loss.

This article will explain everything you need to know about injections for diabetic retinopathy, why they may be necessary when compared to laser therapy, and what you can expect from these eye injections.

Eye injections are currently the only available medications specifically tailored to treat more advanced stages of retinopathy (such as proliferative retinopathy).

With diabetic retinopathy, you may experience symptoms such as:

  • blurry vision
  • dark spots or floaters
  • difficulty seeing colors

Without treatment, diabetic retinopathy can cause blindness.

Anti-VEGF (vascular endothelial growth factor) drugs are the main type of eye injections to treat diabetic retinopathy. These medications slow the growth of abnormal blood vessels in your retina and block leakage from those blood vessels.

Abnormal blood vessel growth in diabetic retinopathy is caused by a protein called VEGF. By blocking the effects of abnormal growth, including stopping the leakage from these blood vessels, these medications help reduce disease progression and improve visual outcomes.

There are 4 main anti-VEGF medications available.

  • Lucentis (ranibizumab) was the first anti-VEGF drug cleared to treat both diabetic retinopathy and diabetic macular edema. It’s a genetically-egineered antibody fragment of the humanized anti-VEGF monoclonal antibody.
  • Eylea (aflibercept) is a recombinant fusion protein of the binding domains of human VEGF-R1 and VEGF-R2, fused with the Fc domain of human IgG1.
  • Beovu (brolucizumab) is a humanized single-chain variable antibody fragment, the smallest functional subunit of an antibody approved for intravitreal use.
  • Avastin (bevacizumab) is one of the common medications for diabetic retinopathy, although it’s used off-label and not directly approved by the Food and Drug Administration to treat this condition. Avastin was first used in 2005. Many eye specialists turn to it before other eye injections because, in addition to being safe and effective, it often comes at a lower cost for patients and insurance companies as a first-line treatment.

Healthcare professionals may also inject steroids into your eyes to relieve symptoms. You may need recurring treatments in order for these to be most successful.

Before an injection, an eye specialist will clean the skin around your eye and cover it with a cloth.

Your eye specialist may hold your eye open with their hand, or they may use small clips to help keep your eyes open and steady. They will give you localized numbing drops beforehand.

Finally, they will guide a very small needle into your eyeball and give you the injection. The entire procedure typically takes only minutes once you’ve met with your eye doctor and been prepped for the injection.

You may need more injections, depending on your eye doctor’s guidance and what they feel is necessary for your diabetic retinopathy development.

You may receive injections once per month or even more frequently, as needed. As your vision stabilizes, you may need fewer injections or stop receiving them.

These treatments should not be painful, as your eye is numbed beforehand.

To ease any possible pain from the injection of anti-VEGF medications, your eye doctor may give you a subconjunctival lidocaine injection first.

You may experience fear and anxiety before the treatments. Healthline’s own Mike Hoskins has had more than two dozen diabetic retinopathy treatments, including eye injections and laser therapy. He has described the anxiety around these injections as being worse than the injections themselves.

After treatments, you may experience itchiness, slight eye irritation, or a feeling of eye “heaviness.” These sensations will likely fade within a day or two of the injection.

It’s important that you contact your eye doctor’s office if you experience severe pain, blurry vision, or other complications after your treatment. These symptoms can indicate an unexpected side effect of the injection that requires medical attention.

Eye specialists often describe eye injections as the preferred option if there is a leaking blood vessel or hemorrhage that needs to be addressed immediately, whereas laser treatment are more commonly used for strategic repair of those vessels and growths.

You may or may not need laser treatment instead of or along with eye injections.

You and your doctor will decide on the best course of action and treatment plan for your specific complications.

Typically, you’ll receive an injection once per month until your vision stabilizes.

After that, your eye doctor may give you injections less often or stop them altogether.

But this will depend on your health history and how your diabetic retinopathy has developed.

A 2021 study found that injections reduced the risk of vision-threatening events by 75% after 2 years in people with existing diabetic retinopathy.

Additionally, another 2021 study suggests that anti-VEGF injections can reduce the severity of diabetic retinopathy and decrease the likelihood that the condition will progress to diabetic macular edema.

There are currently no eye drops that can help treat diabetic retinopathy. But research is exploring the future possibility of eye drops as treatment options.

An ongoing study known as the DR:EAM study is evaluating a novel eye drop that could potentially slow or reverse the progression of diabetic retinopathy.

OTT166 is a novel small-molecule selective integrin inhibitor that targets the integrins, another group of VEGF-driven proteins. Blocking them may help reverse the disease.

Researchers are currently studying treatment options such as oral treatments, non-invasive laser treatments, and surgery. There is no specific timetable for when this research will be finished, nor is there a guarantee that these treatments will eventually be cleared for use.

Diabetic retinopathy is a common diabetes complication, and medicated eye injections are a painless and effective treatment for its more advanced stages.

Injections can slow the progression of diabetic retinopathy and save your remaining vision. You may need an injection once per month until your vision stabilizes, and then your treatments may occur less often or stop altogether.

These procedures happen in an eye doctor’s office. You’ll receive numbing drops to ease any pain and should experience few side effects afterward.