While injections into the eye may seem straightforward, the complications can be quite severe.
Injections may cause adverse cardiac events, perforation of the eye, allergic reactions, or they can result in the drug entering the blood stream if a vein is inadvertently injected.
Optometrists do not have the education, training, or even the costly equipment such as crash carts to deal with these potential complications.
Patient risk also can occur with injections around the eyes, with training and supervised experience to be able to perform through multiple routes and locations, including:
- Nerve blockers
- Retrobulbar injections (behind the eye)
- Intravenous injections
- Intralesional injections
- Intramuscular injections
Any time a needle is placed near the eye, there are serious risks to patients that require clinical experience and judgment. For example:
- A surgical error of just a few millimeters can result in a punctured eyeball and catastrophic vision loss.
- Injecting eyelid lesions, which have blood vessels connecting to the back of the eye, can cause immediate and permanent vision loss.
- Injecting a cancerous lesion that has not been properly diagnosed can result in the cancer spreading.
Expertise in managing these types of serious complications is achieved through years of an ophthalmic surgical residency and clinical training. It cannot be obtained in the current optometric curricula or in an “add-on” training course.