wet macular degeneration

Diagnosed with wmd in September 07, have received several Lucentis injections which have been helping overall.  Problem is, within hours of injection, after local anesthesia wears off, I begin tearing uncontrollably, eye is extremely irritated and this continues for up to 72 hours, gradually getting better.  I am a psychotherapist, and cannot work during this time.  Recovery  takes over 1 week, then I have intermittent soreness for another week, by the time this is all over, it is nearly time for another injection.  I've been considering discontinuing treatment.  Recently I met someone who also gets Lucentis injections, from a different doctor, and he tells me he has none of these problems, just some minor irritation for a few hours immediately after the injection.  Are there some people who respond like me, or could it be my doctor?  I am only 59, and certainly don't want to lose my central vision, but I really can't bear to continue treatment if this is how it must be.  Please advise, and thank you for your consideration.

[Michael J Kutryb, MD]

You probably have some degree of dry eye keratopathy which is worsened not by the injection but by the anesthetic drop and betadine (iodine) prep to the eye.  Both chemicals are irritating to cornea and conjuctiva, especially certain individuals with dry eyes.  My suggestion would be for doctor to maybe use an antibiotic ointment over the eye after the injection and then keep patch on eye for a few hours.  This might violate the protocol for the injection and doctor may need to see if he is ok that with that.  Again, I think it is the prepping agents that are probably to blame. Discuss it with you doctor.

Michael Kutryb, MD