Equally as significant as having the knowledge and skill to perform injections in and around the eye is having the decision-making capabilities to determine when procedures, such as injections, are appropriate.
For instance, injection of chalazia (lumps in or along the edge of an eyelid) with steroids by some optometrists has drawn considerable attention. A significant concern is the crucial diagnostic ability required to accurately identify a lesion as a chalazion. A cancerous lesion or other serious eyelid problems may masquerade as chalazions with potential harm to the patient resulting from either delay in diagnosis or inappropriate treatment. For most ophthalmologists, incision and curettage is preferred over steroid injection, due to the additional risks associated with the medication and the opportunity for diagnostic examination and pathology of the lesion.