Retina and macula

IVOM: delivering medication to the retina.

Intravitreal injection is an established outpatient treatment for conditions in which fluid or abnormal vessels threaten the macula and central vision.

What to expect during treatment Our IVOM locations

Delivered directly where it is needed

What does IVOM mean?

IVOM stands for intravitreal injection. A very fine needle delivers medicine into the vitreous, the gel-like space inside the eye in front of the retina.

Tablets, eye drops and ointments often cannot deliver enough medicine to the retina. Injecting into the vitreous brings the medicine close to the affected macula. Treatment takes place on an outpatient basis, with local anaesthetic eye drops and strictly sterile conditions.

An intravitreal injection is not an injection ‘behind the eye’ and usually does not require general anaesthesia. Giving the medicine takes only a few seconds. Preparation, disinfection and checks take considerably longer because safety and hygiene are essential.

When it is commonly used

What diseases do we treat?

Fluid in the macula is a finding, not a diagnosis by itself. The underlying disease determines the medicine, treatment goals and follow-up.

AMD

Wet age-related macular degeneration

In neovascular or ‘wet’ AMD, abnormal leaking vessels grow beneath or within the retina. Fluid and blood can damage the macula and reduce central vision.

DME

Diabetic macular oedema

Retinal vessels damaged by diabetes can leak fluid. If swelling affects the area of sharpest vision, reading, recognising faces and driving may become much harder.

RVV

Macular oedema after vein occlusion

A blocked retinal vein causes blood to back up. Bleeding and fluid in the macula can cause a sudden or increasing loss of vision.

CNV

Further abnormal blood vessel growth

Intravitreal treatment may also help with abnormal new blood vessels caused by other conditions, such as high myopia. The precise diagnosis determines whether it is appropriate.

Choice of medicines

How do the medicines work?

We choose the medicine and schedule according to diagnosis, disease activity, previous response and personal risks.

The most common treatment approach

Anti-VEGF medicines

In many retinal diseases, signalling proteins such as VEGF play an important role. They encourage abnormal blood vessels to grow and make vessel walls more permeable. Medicines that block these signals can help reduce fluid build-up and swelling.

They are mainly used for wet AMD, diabetic macular oedema, swelling after retinal vein occlusion and certain other forms of abnormal vessel growth.

For selected conditions

Steroid medication

Steroids mainly act on inflammation and increased leakage from blood vessels. For some conditions, they can be given as a longer-lasting implant, for example when diabetic macular oedema has not responded sufficiently to previous treatment.

Steroids can raise eye pressure and contribute to cataract formation. We therefore pay particular attention to the lens, glaucoma risk and regular pressure checks.

We agree the appropriate medicine during your consultation. Do not change it, skip doses or alter the intervals on your own.

Basis of each decision

Diagnostics and follow-up.

One image is rarely enough. We assess visual function, retinal examination, OCT and changes over time together.

Visual acuity and symptoms

We assess central vision and ask about distorted lines, spots or changes in the perceived size of objects.

Examining the retina

With the pupils dilated, we assess the macula, retinal vessels, bleeding and other changes at the back of the eye.

Optical coherence tomography

OCT shows the individual retinal layers, making fluid, swelling and macular changes clearly visible and comparable over time.

Vascular imaging if needed

Fluorescein angiography or additional OCT angiography can show leaking vessels and abnormal new vessel growth.

Eye pressure and anterior segment

We pay particular attention to eye pressure, the lens and individual risks if steroid treatment is being considered.

Health and medicines

Planning includes existing conditions, allergies, previous eye surgery and all medication. Never stop blood thinners on your own.

Not every treatment is the same

Why are several IVOM injections often needed?

How long the effect lasts depends on the medicine and condition. Retinal diseases can become active again and need long-term monitoring.

Start of treatment

Treatment often starts with several injections at set intervals. The number depends on the condition, approved medicine and your examination findings.

Evaluate activity

Visual acuity, retinal examination and especially OCT show whether fluid is decreasing, the macula stays dry or disease activity has returned.

Adjust Intervals

If your condition allows, we can gradually extend the time between treatments and shorten it again if disease activity returns. Other regimens give treatment only when a need is confirmed.

Regularity protects the treatment result.

Do not postpone or stop a planned course of treatment without consulting us. Even if your vision seems stable, OCT can reveal renewed disease activity before you notice a change.

The day of treatment

Carefully prepared, carried out in a few minutes.

Treatment is minimally invasive. Sterile procedures before and after the injection are an essential part of keeping it safe.

Arrival and preparation

We check your identity, the eye being treated, the medicine and consent. Tell us about current infections, new symptoms or changes to your medication.

Anaesthesia and disinfection

Anaesthetic drops numb the eye’s surface. The eyelids, lashes, skin and conjunctiva are carefully disinfected, and a small holder keeps the eye open.

Intravitreal injections

A very fine needle passes through the white of the eye to deliver medicine into the vitreous. The injection itself takes only a few seconds.

An immediate check

Immediately afterwards, we check whether you can see light or fingers. Further checks may be needed before you leave the practice.

Aftercare and next appointment

We provide individual advice and the date for your check-up or next treatment. OCT helps determine the next interval.

Two outpatient surgery sites

IVOM in Berlin.

Intravitreal injections are available at both Savignyplatz and Greifswalder Straße.

Savignyplatz

Outpatient surgery centre
Carmerstraße 7
10623 Berlin-Charlottenburg

View Location

Greifswalder Straße

Outpatient surgery unit
Greifswalder Straße 137–138
10409 Berlin-Pankow

View Location

After an intravitreal injection

What is normal, and when should you act?

Most symptoms are mild and settle quickly. Some changes, however, need attention before your next routine appointment.

Mostly temporary

Mild burning, grittiness or a foreign body sensation
Small moving spots or air bubbles in your vision
mild redness or limited bruising on the white of the eye
temporary blurred vision immediately after the procedure

Do not rub the eye. Keep water, dirt and cosmetics out of it during the first few days, and always follow your personal aftercare instructions.

Urgent warning signs

increased or severe eye pain
significantly increasing redness
Rapid or marked deterioration in vision
strong sensitivity to light, swelling or secretion
Many new floaters, flashes or a dark curtain appearing suddenly

Seek immediate assessment by an ophthalmologist. Do not wait for your next check-up. If we are unavailable, contact an eye hospital or the out-of-hours medical service on 116117; for a serious injury or a potentially life-threatening condition, call 112.

Guidance for urgent symptoms

Benefits and safety

A clear, balanced explanation of the risks

Intravitreal injections are among the most common eye procedures. Serious complications are rare, but need clear explanation and early recognition.

Risks of surgery

Eye infection (endophthalmitis)
Inflammation or temporary increase in pressure
Bleeding in the eye
Retinal tear or retinal detachment
Injury to the lens or other eye structures

Considerations relating to medication

possible inflammatory reactions
Individual intolerance or inadequate response
Steroids: increased eye pressure and a greater risk of cataracts
with anti-VEGF medicines: consider general vascular risks in the medical history

Limits of therapy

permanently damaged retinal cells cannot be restored
The improvement in vision varies from person to person
Recurrence and further fluid build-up are possible
long-term checks and repeated treatment may still be needed

This list does not replace a personal discussion of the risks. Please tell us about recent vascular events, serious illnesses, pregnancy, allergies and all medicines you take.

Frequently asked questions

What patients want to know before an IVOM.

Does the injection hurt?

Anaesthetic drops numb the eye’s surface beforehand. Many people feel brief pressure or touch rather than pain. Mild stinging or irritation may occur as the anaesthetic wears off.

How long is the appointment?

The injection itself takes only a few seconds. Please allow considerably more time for registration, preparation, anaesthetic drops, sterile cleaning, treatment and the check afterwards. The exact arrangements may vary between appointments.

Why do I have to come back so often?

The effect is temporary, and the underlying condition may become active again. Regular checks and timely retreatment help preserve the result as well as possible.

May I continue to take blood thinners?

Never change anticoagulants on your own. They often do not need to be stopped for an intravitreal injection, but your treating team decides according to your situation.

Can I drive after treatment?

Disinfectant, small air bubbles or dilated pupils may affect your vision immediately after an intravitreal injection. Do not drive again until your vision has recovered sufficiently and you meet the legal requirements.

Does IVOM cure retinal disease?

Treatment can control disease activity, reduce fluid and preserve or improve vision. Many underlying conditions remain chronic, however, and need long-term monitoring.

Medical note

This page provides general information and cannot replace an eye examination. Whether an intravitreal injection is appropriate, which medicine to use and how often treatment is needed can only be decided after assessing your individual condition.

Medical basics