PostOp Eyes

Eye Injections (Intravitreal Injections) Recovery: What to Expect

Illustration for an eye injection recovery

General information about typical recovery, not medical advice. Every eye and every surgery is different, and your surgeon's instructions override anything on this page. Read our full disclaimer.

An intravitreal injection is a shot of medicine placed into the gel inside the eye. It is the standard treatment for wet age-related macular degeneration, diabetic macular edema and diabetic retinopathy, and swelling from a retinal vein occlusion. The medicines most often used are anti-VEGF drugs, sold as Avastin (bevacizumab), Lucentis (ranibizumab), Eylea (aflibercept) and Vabysmo (faricimab). Which drug you get is your retina specialist's decision. The recovery described on this page is about the injection itself, and it looks about the same no matter which of these drugs is in the syringe.

The visit is short. It happens in the office, not an operating room. Your eye and eyelids are numbed with drops or gel, the eye is cleaned with povidone-iodine (the yellow-brown antiseptic), a small clip holds your eyelids open, and the medicine goes in through the white of the eye with a very thin needle. The American Society of Retina Specialists says the whole process takes about 10 to 15 minutes and that patients typically feel pressure, with little or no pain during the injection itself.

Here is the part that surprises most people: the sore, scratchy, watery eye you have that evening and the next morning is usually not the medicine. It is the antiseptic and the needle. The ASRS specifically says the feeling that something is in your eye can be a reaction to the povidone-iodine used to clean the eye, and that the small red spot on the white of the eye is where the needle went in. Both settle on their own. The medicine itself works quietly inside the eye and you cannot feel it working.

This is a treatment you repeat, not a one-time surgery. The National Eye Institute says most people getting anti-VEGF injections need them about once a month at first, and that over time you may need them less often. The American Academy of Ophthalmology describes a range from every few weeks to every few months, roughly 6 to 12 visits a year on older schedules and sometimes only 3 to 4 a year on newer ones. In practice most patients land somewhere between every 4 weeks and every 16 weeks. None of this page replaces what your retina specialist tells you. Their instructions override everything here.

The typical timeline

Typical full recovery: 24-48 hours for most irritation. Ranges below are what published guidance describes for most people; your surgeon may set different limits for your eye.

StageWhat to expectRestrictions
The first few hoursDay 0The numbing wears off over the first hour or two and the eye starts to feel scratchy or gritty, like an eyelash is stuck under the lid. The AAO says you may have some eye irritation for a few hours after the injection. Vision is often smeary or dim right away from the antiseptic, the lubricating gel and any dilating drops, and you may see dark floating spots or bubbles moving in your vision. The eye may water and look pink. Eye pressure goes up briefly during the injection but the ASRS says it usually returns to baseline within a few minutes.The ASRS says there are usually no restrictions after the injection apart from avoiding potential contamination of the eye on the day of the injection. That means no rubbing, no swimming or hot tubs, no eye makeup and nothing dirty near the eye for the rest of that day. Arrange a ride if you were dilated or if your vision is smeary.
The rest of day 1Day 0-1This is usually the most uncomfortable stretch. The gritty feeling, watering and a dull ache are common the evening of the shot and the next morning. A qualitative BMJ Open study of injection patients found some described soreness and irritation lasting up to about 36 hours. You may notice a bright red patch on the white of the eye where the needle entered. Floating spots and air bubbles are common. The NEI says these usually go away within a day or two.Do not rub the eye. Preservative-free artificial tears can be used for the surface irritation. If your retina specialist gave you drops or specific limits, follow those instead. Watch for the warning signs listed further down: pain that is getting worse rather than better, vision that is getting worse, or new light sensitivity.
Days 2 to 7Day 2-7For most people the scratchy feeling is gone or nearly gone by day 2 or 3, and the eye feels like itself again. The red spot on the white of the eye is the slowest thing to go. The ASRS says a subconjunctival hemorrhage at the needle site usually heals within a week, and the AAO says the same. It may change color from bright red to orange or yellow as it clears, which is normal healing, not a new problem. Any floaters or bubbles from the injection usually fade over this stretch.Normal activity. The NEI says most people can go back to their normal activities right after the treatment. This is also the window when the rare but serious infection called endophthalmitis shows up. In one series of infections after anti-VEGF injections the median time from the shot to the patient showing up was 4 days, with a range of 1 to 18 days. So if pain and blurring are getting worse instead of better during this week, call the retina office rather than waiting.
Until your next injectionWeek 2 to your next visit, often 4 to 16 weeksThe eye should feel completely normal. Vision changes from the medicine, if any, come slowly over weeks as swelling or leaking settles down, not on the day of the shot. The NEI is direct about this: injections do not change your vision right away. The ASRS says the follow-up visit is usually about 4 to 6 weeks after the injection, though the interval depends on the disease being treated. Many patients get stretched out over time, and the AAO describes schedules ranging from every few weeks to every few months.No restrictions between injections beyond whatever your retina specialist has told you. Keep the appointments even when your vision feels fine, because the medicine is holding the condition in check rather than curing it. Report any sudden change in vision, a new shower of floaters, flashes or a shadow at any point between visits.

Day by day

When can I...

Is this normal?

Common questions

How long does the gritty feeling last after an eye injection?
For most people it eases within about 24 to 48 hours. It starts as the numbing wears off, is usually worst the evening of the injection and the next morning, then fades. The ASRS says the feeling that something is in your eye can be a reaction to the povidone-iodine used to clean the eye before the injection, and the AAO says you may have eye irritation for a few hours. A qualitative BMJ Open study of injection patients found some described soreness and irritation lasting up to roughly 36 hours. If it is still significant after two or three days, or if it is getting worse rather than better, call your retina office.
Can I take my regular medicines around an eye injection?
Do not stop or change anything on your own, and ask your retina office what they want. The ASRS says there are usually no restrictions after the injection apart from avoiding potential contamination of the eye that day, and the NEI says most people can go back to their normal activities right after the treatment. Neither source describes stopping routine medicines for a standard anti-VEGF injection. Blood thinners and aspirin can make the red spot on the white of the eye larger or more frequent, which is a cosmetic issue rather than a dangerous one, but the decision to hold any medicine belongs to the doctor who prescribed it and to your retina specialist, not to this page.
Why does my eye water so much after the injection?
Because the surface of the eye is irritated, mostly by the antiseptic. The ASRS attributes the post-injection feeling that something is in your eye to the povidone-iodine used to clean the eye, and says artificial tears can be used to ease dryness and surface irritation. Reflex tearing comes with that irritation, so the watering usually starts and stops alongside the gritty feeling, generally settling within a day or so. Blot the tears rather than rubbing the eye. Watering with thick discharge, spreading redness, increasing pain or worsening vision is a reason to call the office, since the AAO lists those as symptoms patients should report promptly.
Does the injection wear off, and why do I need another one?
Yes, the effect is temporary, which is why this is a repeating treatment rather than a cure. The medicine blocks VEGF, the protein that makes blood vessels leak and grow abnormally, and when the drug clears the eye the leaking can return. The NEI says most people getting anti-VEGF injections need them about once a month at first and may need them less often over time, that some people can eventually stop, and that others need to keep getting them to protect their vision. The AAO describes injection frequency ranging from every few weeks to every few months, roughly 6 to 12 visits a year on older schedules and as few as 3 to 4 a year with some newer drugs. The ASRS says follow-up is usually about 4 to 6 weeks after the injection depending on the disease. Keep the appointments even when your vision feels fine.
What helps the irritation after an eye injection?
Preservative-free artificial tears are the mainstay. The ASRS says artificial tears, preferably sterile single use droppers, can be used to help ease symptoms of dryness and surface irritation, and single use vials avoid preservatives that can sting an already irritated eye. Use them as often as they help. Do not rub the eye, since rubbing a numb, antiseptic-coated surface can scratch it and make things last longer. Cool is also worth mentioning: a randomized trial published in Retina in 2020 found that an ice pack applied to the closed eyelid shortly before the injection significantly lowered pain scores at 1 and 10 minutes afterward, so a cool compress on the closed lid is a reasonable comfort measure, though that study tested it before the shot rather than at home hours later. Ask your retina office before using any drop or medicine they did not give you.

Sources