Injections for macular degeneration (anti-VEGF)

Regular injections into the eye that aim to control wet age-related macular degeneration and protect central vision, usually needing repeat treatment over a long period.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

Anti-VEGF injections control wet AMD and protect central vision, but they are usually an ongoing treatment, not a cure.
Most people need loading injections then repeat injections for months or years; stopping too soon can let vision worsen.
Treatment often stabilises vision and can improve it, but it cannot reverse damage that has already happened.
Serious eye infection (endophthalmitis) is rare but an emergency — a painful, red eye with worsening vision after an injection needs urgent care.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeEye injection (outpatient course)

AnaestheticAnaesthetic eye drops or gel; the eye is numbed first

How long it takesThe injection itself takes a few minutes; the visit is longer

Hospital stayOutpatient — no hospital stay

Time off workUsually none, but vision may be blurred for a short time and you should not drive straight afterwards

When you'll see resultsOften stabilises vision and can improve it; benefit is judged over the first months

On the NHS?Anti-VEGF injections for wet AMD are commonly available on the NHS when criteria are met

A general guide. Your specialist will give you advice for your situation.

Best fit

Can stop wet AMD from getting worse in many people

Pause if

Dry AMD does not respond to anti-VEGF injections, which are for the wet (neovascular) type.

Main recovery point

The eye may feel gritty, watery or mildly sore and vision can be blurry. Avoid rubbing the eye and do not drive until your vision is clear.

Good aftercare

Clear, written warning signs of infection and an urgent same-day contact route.

First few hours

The eye may feel gritty, watery or mildly sore and vision can be blurry. Avoid rubbing the eye and do not drive...

First few days

Any red patch on the white of the eye and grittiness usually settle. Watch for increasing pain, redness or...

First weeks

After loading injections the specialist checks, often with a scan, whether the leakage is settling and how your...

Months

Repeat injections continue on a schedule guided by scans, with the gaps sometimes lengthened if the disease stays...

Medical line illustration of retina imaging and treatment planning for Injections for macular degeneration (anti-VEGF). — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What are anti-VEGF injections for macular degeneration?

Wet age-related macular degeneration (wet AMD) is when abnormal blood vessels grow under the centre of the retina (the macula) and leak fluid or blood, quickly blurring or distorting central vision.

Anti-VEGF medicines are injected into the jelly of the eye to block the signal that drives these abnormal vessels. This dries up the leakage, often stabilising vision and sometimes improving it. UK medicines include ranibizumab, aflibercept, faricimab and, used off-label, bevacizumab.

The most important thing to understand is that this is usually an ongoing treatment, not a one-off cure. Most people start with several injections close together (loading doses) and then continue with repeat injections, often for years, to keep the disease controlled. If injections stop too soon, vision can get worse again. The injections are generally well tolerated, and a serious eye infection (endophthalmitis) is rare but important to recognise quickly.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Ranibizumab

A widely used anti-VEGF medicine for wet AMD, given as a course of injections into the eye, with a biosimilar version also available in the UK.

Aflibercept

An anti-VEGF medicine that often lasts longer between injections, so the gaps can sometimes be longer than with ranibizumab.

Faricimab

A newer injection that blocks two signals and may allow longer intervals between treatments for some people.

Bevacizumab

A closely related anti-VEGF medicine used off-label for wet AMD in some settings; effective but not licensed specifically for the eye.

Treat-and-extend and PRN schedules

Rather than fixed monthly injections, many clinics gradually extend the gap between injections (treat-and-extend) or treat only when the disease is active (as-needed), guided by scans.

How anti-VEGF treatment is usually given

Phase	What happens	Why
Loading	Several injections close together	To get the disease under control quickly
Maintenance	Repeat injections, often every 4–8+ weeks	To keep leakage controlled
Monitoring	Regular scans (OCT) of the macula	To time injections and catch flare-ups

Schedules vary by medicine and by how your eye responds. Your specialist will explain your plan and how long treatment may continue.

Preparing for your injection

Understand that this is usually a long-term course of repeat injections, not a single treatment.
Arrange not to drive home, as your vision may be blurred and the eye uncomfortable for a short time.
Tell the team about any eye infections, recent eye surgery, or allergies before each injection.
Mention if you are on blood thinners, though injections are usually still possible.
Plan for regular visits and scans over months to years, and how you will get to them.
Ask which medicine you will have, how often, and how the gaps between injections will be decided.

What happens

The injection is done as an outpatient in a clean treatment room. The eye is numbed with anaesthetic drops or gel, the surface is cleaned with an antiseptic, and a small clip gently holds the eyelids open.

The specialist injects a tiny amount of medicine through the white of the eye, to the side, so you do not see the needle coming. It usually feels like brief pressure rather than pain and takes only a minute or two. You may notice floaters, a small red patch on the white of the eye, or mild grittiness afterwards. The eye is checked and you are given advice before you go home.

Is this injection right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

Dry AMD does not respond to anti-VEGF injections, which are for the wet (neovascular) type.
An eye with advanced scarring at the macula may gain little from injections.
An active eye infection means an injection must be delayed.
Some people cannot commit to the frequent visits needed, which should be discussed honestly.

Delay or rearrange if…

There is an active infection in or around the eye.
You have recently had eye surgery that needs to settle first.
You are unwell with a condition that makes a sterile procedure unsafe for now.
Important scans confirming active disease are still awaited.

Alternatives to discuss

Watchful monitoring for dry AMD or inactive disease, with home vision checks.
A different anti-VEGF medicine or schedule if one is not working or not tolerated.
Photodynamic therapy in selected, unusual cases where offered.
Low-vision support, magnifiers and registration for sight impairment to maintain independence.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Comfort, sedation or contrast choices

If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.

Anaesthetic eye drops or gel

Numb the surface of the eye before the injection; this is the usual method.

Subconjunctival local anaesthetic

Occasionally a small amount of anaesthetic is placed under the surface for added comfort.

Benefits

Can stop wet AMD from getting worse in many people
Can improve central vision in some people, especially when started early
Reduces leakage of fluid and blood at the macula
Done as a quick outpatient treatment without a hospital stay
Helps protect the ability to read, recognise faces and stay independent

Risks & complications

More common

A red patch on the white of the eye where the needle went in
Gritty, sore or watery eye for a day or so
Floaters or seeing the medicine move in your vision briefly
Needing repeat injections over a long period

Less common

A short-lived rise in pressure inside the eye
Bruising or irritation from the eyelid clip and antiseptic
A small bleed under the surface of the eye that looks dramatic but settles
Reduced response over time, needing a change of medicine or schedule

Rare but serious

Serious infection inside the eye (endophthalmitis), which can threaten sight
Injury to the lens (cataract) or a retinal tear or detachment from the needle
Inflammation inside the eye, or a small risk of stroke or heart attack discussed with your specialist

Two things matter most. First, this is usually a long-term commitment: missing injections can let the disease become active again and damage vision. Second, although a serious eye infection (endophthalmitis) is rare, it is an emergency — an increasingly painful, red eye with worsening vision in the days after an injection needs urgent assessment. Ask your specialist how often you will need injections, how long treatment may continue, and exactly what to do if your eye becomes painful afterwards.

Published figures to discuss

How much vision is gained or kept depends on how early treatment starts, how the disease behaves and how regularly injections are given. Serious complications are rare per injection, but the risk adds up over a long course, so safe technique and prompt recognition of infection matter.

Figure	Reported range	How to interpret it	Source / confidence
Serious infection inside the eye (endophthalmitis)	Rare — around 0.05% per injection (roughly 1 in 2,000) in large series; a pooled estimate of about 0.056%	An emergency; a painful, red eye with worsening vision after an injection needs urgent care.	Endophthalmitis rates among anti-VEGF patients: claims analysis — PMCpmc.ncbi.nlm.nih.govPublished figure
Short-lived raised pressure inside the eye	Common immediately after injection but usually short-lived; persistent pressure rise is much less common	Monitored at appointments, especially over a long course of injections.	Endophthalmitis rates among anti-VEGF patients: claims analysis — PMCpmc.ncbi.nlm.nih.govSource-linked context
Retinal tear or detachment from the injection	Rare, generally well below 1 in 1,000 injections in large series	Why new floaters, flashes or a shadow after an injection should be reported promptly.	Endophthalmitis rates among anti-VEGF patients: claims analysis — PMCpmc.ncbi.nlm.nih.govPublished figure

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is no real physical recovery from a single injection, but your eye may be gritty and red for a day or so, and your vision can be blurry briefly, so you should not drive straight afterwards. The bigger picture is the ongoing course of treatment and monitoring.

First few hours

The eye may feel gritty, watery or mildly sore and vision can be blurry. Avoid rubbing the eye and do not drive until your vision is clear.

First few days

Any red patch on the white of the eye and grittiness usually settle. Watch for increasing pain, redness or worsening vision, which need urgent review.

First weeks

After loading injections the specialist checks, often with a scan, whether the leakage is settling and how your vision is responding.

Months

Repeat injections continue on a schedule guided by scans, with the gaps sometimes lengthened if the disease stays quiet.

Ongoing

Treatment and monitoring often continue for years; stopping is considered only when your specialist judges the disease is stable or treatment is no longer helping.

What's normal — and not a worry

A red patch on the white of the eye that fades over days
Gritty, watery or mildly sore eye for a day or so
Floaters or seeing the medicine move briefly after the injection
Blurry vision for a short time after treatment
Knowing you will return for more injections and scans

Aftercare

Do not rub the eye, and avoid swimming and dusty environments for a day or two.
Use any drops you are given as directed, and do not drive until your vision is clear.
Watch closely for increasing pain, redness or worsening vision in the days after an injection.
Attend all injection and monitoring appointments, even if the eye feels fine.
Use an Amsler grid or check each eye separately at home if advised, to spot changes.
Keep a record of which eye and which medicine you receive at each visit.
Know the urgent contact route for signs of infection.

Before your injection

A lift home arranged (no driving after the injection)
Any prescribed drops collected
Amsler grid or home vision check set up if advised
Injection and scan appointments noted
List of medicines and allergies ready for the team
Emergency eye contact number saved

Scars and how they heal

There is no skin scar. The needle passes through the white of the eye and often leaves a small red patch (like a bruise on the eye surface) that clears over days. There is no external mark.

⚠ Get urgent help if…

Increasing eye pain in the days after an injection
Worsening redness and the eye becoming very sensitive to light
Worsening or sudden loss of vision after an injection
Increasing floaters, flashes or a shadow or curtain in your vision
Discharge from the eye or feeling generally unwell with eye symptoms

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A good result is that the leakage at the macula dries up and your central vision stabilises, and sometimes improves, particularly if treatment is started early. The benefit is judged over the first months using your vision and scans of the macula.

Injections cannot reverse scarring or damage that has already happened, and the disease can become active again if treatment stops or stretches too far apart. Your specialist should be clear that the aim is long-term control of the disease, not a one-off cure.

How long it lasts

Anti-VEGF treatment controls wet AMD rather than curing it, so the benefit lasts as long as the disease stays suppressed. Many people need injections for years, with the gaps adjusted to how the eye responds. The other eye is also at risk over time, so both eyes are monitored.

Related tests, treatments or support

Anti-VEGF injections are sometimes combined with other treatments depending on the cause of the leakage. The same injections are also used for other conditions such as diabetic macular oedema and retinal vein problems, and laser or surgery may occasionally be added. Your specialist will explain what is right for you.

Follow-up & long-term care

You will be followed up regularly, usually with scans of the macula, to decide when the next injection is needed and whether the gaps can be lengthened. Report any increasing pain, redness or sudden vision change between appointments straight away.

Repeat injections on a schedule guided by scans, often for years
Regular OCT scans and vision checks to time treatment
Home monitoring of each eye (for example with an Amsler grid) if advised
Monitoring of the other eye for new wet AMD
Prompt review of any sudden distortion or central blur

Repeat, follow-on and what comes next

This is an ongoing treatment: repeat injections are the norm, often for years.
The medicine or schedule may be changed if the response fades or the eye does not tolerate it.
The gaps between injections are adjusted up or down based on scans.
The second eye may later need its own course of injections.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

Clear, written warning signs of infection and an urgent same-day contact route.
A defined injection and monitoring schedule, with scans to guide it.
Honest discussion of how long treatment may continue and how progress is measured.
Monitoring of both eyes and support such as low-vision services if vision is affected.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

Which anti-VEGF medicine is used and its cost
Number of injections, including loading doses and ongoing maintenance
Specialist (ophthalmologist) fee and treatment-room or facility fee
Regular OCT scans and monitoring visits
How long treatment continues, which is often years
Whether the second eye also needs treatment

Make sure your written quote includes

The cost per injection, including the medicine and the procedure
The likely number of injections over the first year
Scan (OCT) and monitoring visit costs
Whether a course or only single injections are quoted
What ongoing treatment is likely to cost over time
What happens, and what it costs, if a complication such as infection occurs

On the NHS? Anti-VEGF injections for wet AMD are commonly available on the NHS when the eye meets treatment criteria; private care is used mainly for speed of starting treatment or choice of provider.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Choosing a specialist safely

Check the specialist is on the GMC Specialist Register for this area.
Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Questions to ask your medical professional

Take this to your consultation. A good specialist will welcome every one of these.

Which medicine will I have, and why is it the right choice for me?
How often will I need injections, and how long might treatment continue?
How will you decide when to lengthen the gaps between injections?
What exactly should I do if my eye becomes painful or red after an injection?
How will you monitor my other eye?
What happens to my vision if I have to miss injections?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the specialist who carries out my injection, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this injection not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

How often will I need injections?

Most people start with several injections close together, then continue with repeat injections, often every 4 to 8 weeks or longer, adjusted to how the eye responds. Treatment may continue for years.

Is this a cure?

No. The injections control wet AMD rather than curing it. If treatment stops too soon the disease can become active again and vision can worsen.

Does the injection hurt?

The eye is numbed first, so most people feel pressure rather than pain. The eye can be gritty or sore afterwards for a day or so.

What is the most serious risk?

A serious infection inside the eye (endophthalmitis) is rare but an emergency. An increasingly painful, red eye with worsening vision after an injection needs urgent assessment.

Can I drive after the injection?

Not straight away — your vision may be blurry for a short time. Arrange a lift and do not drive until your vision is clear.

Are these injections available on the NHS?

Yes. Anti-VEGF injections for wet AMD are commonly available on the NHS when the eye meets the treatment criteria. Private care is used mainly for speed or choice.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: Macular Society — Wet age-related macular degeneration Macular Society — Macular disease treatments NICE — Ranibizumab and pegaptanib for wet AMD (TA155) Royal College of Ophthalmologists — patient information Incidence of endophthalmitis after anti-VEGF injection — Scientific Reports Endophthalmitis rates among anti-VEGF patients: claims analysis — PMC

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.