Injections have an important role in optometry, speaker says

Issue: April/May 2013

ATLANTA – More optometrists will be using injectable medications for diagnostic and therapeutic primary eye care as privileges expand, a lecturer said here at the SECO meeting.

“If you can’t do injections, you have a tendency to think they’re not significant,” David K. Talley, OD, FAAO, told attendees at a continuing education symposium. “But I assure you, once your privileges are changed you’ll find there are a lot of procedures and patients that need injectable medications to treat them as part of their primary eye care.”

One example of the use of injectables for the diagnosis of ocular disease is fluorescein angiography.

“Many thought fluorescein angiography would become extinct with the advent of ocular coherence tomography,” Talley said. “That’s not happening. More scanning laser technology instruments are trying to merge with fluorescein angiography technology.”

Injectables for treatment include intralesional steroid injection for chalazion, Botox (botulinum toxin type A, Allergan) for blepharospasm, autologous injection for filtering blebs, intravitreal injections, surgical procedures of the eyelids, chalazion incision and curettage, and entropion repair.

“Clearly, there’s a comfort level with these,” Talley said, “but a few ODs are doing intravitreal injections.”

Vitreosolve (Vitreoretinal Technologies) is injected into the cavity of the eye, liquefying the vitreous gel.

“Data from those with posterior vitreous retractions suggest that subjects were seven times less likely to develop proliferative diabetic retinopathy,” Talley said. “And all patients said their floaters were also gone.

“How many patients just complain about floaters?” he asked. “We may have a medical treatment for floaters in the future… and also a treatment for posterior vitreous detachment. You must do intravitreal injections.”

Disclosure: Talley has no relevant financial interests.