Eye Blog

It is common practice to prescribe prophylactic antibiotic eyedrops following an injection into the eyeball (intravitreal injection). The purpose of prophylactic antibiotic treatment is to 'prevent' infections from occurring. Although rare (less than 1 in 1000 injections), infections of the eye following intravitreal injections or endophthalmitis , can be severe and sight threatening.

There are at least two good reasons not to prescribe antibiotic eyedrops following an intravitreal injection: Firstly, there is no clear evidence to show that it does actually reduce the risk of infection. Several large studies have found no difference in the endophthalmitis rates between groups of patients receiving antibiotic eyedrops after an intravitreal injection versus those who did not. Secondly, it is a well known fact that the indiscriminate use of antibiotics leads to antibiotic resistance, making infections more difficult to treat when they do occur.
(Go to www.antibioticguardian.com for further information and to make a pledge).

A recent survey of over 150 patients receiving intravitreal injections in my service at Whipps Cross University Hospital revealed that 86% believed post-injection antibiotics reduce the risk of infection. This reflects the information provided by our doctors to the patients during the consenting process and is based on the guidelines published by the Royal College of Ophthalmologists in 2009.

Surely the time for change has come...