Painful Eye Injections - Betadine the Cause?

by Susan
(St. Louis)


I have had 18 injections to treat wet macular degeneration. The nurse told me it's betadine solution that causes the pain in my eye.

I hardly notice the injection, but the betadine antiseptic is painful for hours afterwards.

My doctor uses betadine over the eyelid and around the eye. My eye is rinsed afterwards, but the damage is done.

The solution seeps into my eye causing it to burn and weep for 16 hours or more. It drains into my sinuses and causes them to burn. A near migrain headache also results. I spend most the day in bed, trying to sleep through the pain.

Is there another means to keeping the eye "clean" without this painful antiseptic? Do you know if this is standard practice?


Hi Susan,

I have noted similar reactions in a few of my patients. I agree, it is the Betadine. While I will omit the Betadine from the prep in my patients, other doctors might be hesitant.

I have included an article I wrote about "painful" intraocular injections here:

Painful Introcular Injections

Randall V. Wong, M.D.

Retina Specialist Fairfax, Virginia

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Aug 30, 2017
Betadine hurts!
by: Anonymous

After 18 months worth of Lucentis injections, this month my eye doctor and his practice decided (without informing me!) to change their injection protocol to Betadine drops in the eye both before and after the shot. Talk about pain! By the time I got home, I was in agony. I had red burn marks under my brow and eye, my lids swelled up and my eye watered nonstop for 12 hours and for 3 days my vision was blurry and my eye sensitive to light. I took a picture to show the doctor next month and I will insist that "betadine sensitivity" be listed in my records! I WILL NOT ALLOW MYSELF TO BE PUT THROUGH THIS EVER AGAIN!

Aug 12, 2017
It is the Betadine!
by: Tennessee

Twice now after injections for wet macular degeneration, I have ended up in emergency room due to severe pain. Doctor's nurse said artificial tears would correct the problem - nope, not a bit. I went to the hospital with an ice pack on my eye in an attempt to numb the pain. My eye doctor thinks I am a baby. Time for a new doctor.

Jun 16, 2017
So what is the alternative?
by: Fire in the eye!

I, too, am having 12+ hours of extreme pain in and around my eye after betadine prep for Avastin injection. For those of us with this bonified sensitivity to betadine, what's the alternative for the prep?

Of course, I understand the need for a good prep to prevent infection (that can lead to blindness) one wants that! Meanwhile, however, there should be something in this wonderful world of medicine to prep the eye properly and not burn and damage tissues at the same time...and repeatedly for ongoing treatment! Help! (Antibiotic drops prior to? Other options?) I am interested to hear what else could be used!

Apr 30, 2017
More about Betadine in the eyes
by: Marilyn Gorder

I have had monthly injections for macular degeneration in both eyes for eleven years. The Betadine is becoming extremely painful because my eyes now bleed from every injection--truly awful when it bleeds into the vitreous. I think my eye tissue has weakened from so many injections.

My doctor applies the betadine with a small cotton swab, one eye at a time, immediately before each injection. He gives the injection on that small spot. However, it seems that no amount of washing the eye will relieve the pain.

Can not a less painful antibiotic be used? Or invented? There is a small fortune waiting this development.

Feb 15, 2017
Painful aftermath of Eylea injection
by: Anonymous

I had an eylea injection 3 days ago and the pain is finally beginning to subside, not to mention the sinus irritation caused by this injection. I have been getting injections for 2 years now and it seems the pain is getting so bad and I am thinking of stopping the injections.

A day or two before the injection I actually start getting panic attacks because I know what is coming. The injections are painful and the aftermath is horrible, intense pain that last anywhere from 24 to 48 hours. I asked about rinsing the eye and my Doctor told me this does no good. Who am I to believe.

I do not notice any difference, in fact, my vision was okay until I got the first injection and it has been downhill all the say since. No one at the doctor's office seems to have any sympathy.

Oct 19, 2016
YES, it is the Betadine that causes the damage.
by: Bettie

I am now in treatment for wet macular degeneration in both eyes for FIVE years. My pain has been completely dependent on how small a dose of betadine I am given. My current doctor shows no sign of believing me when I tell him that I am allergic to betadyne. A different doctor got concerned after I ended up with stage two burns under by eyelids. This was accompanied by blisters and unbearable pain. He cut the dose to one small drop with immediate flushing with water afterwards until my eye did not burn.

Now I am back with a previous doctor. Yesterday, I had a very young and inexperienced technician who kept pouring the betadine to my eye no matter what I said. Then there was a delay in the doctor coming in and by then my eye felt fried. I ended up in the emergency room with scorching red face around the eye and cheek area, bright red eyeball and eyelids, water pouring out of my eye and also out my nostril next to the affected eye. Pain was beyond description.

I was amazed to see on my discharge papers that I must have had an abrasion on my eyeball for this to happen. What is so scary about making it official? BETADINE CAUSES PAINFUL BURNS to the face and eye lid and eye ball.

Is there anyone out there in the medical field that will come to our rescue?

Aug 24, 2016
Beatadine Reaction
by: Anonymous

I have had 3 injections so far and the first one, my eye was in unbearable discomfort. The key is to have the nurse flush your eye aggressively after the procedure. I found this to alleviate the pain rapidly.

The previous two injections have been a cake walk since I had asked to receive more flushes of eye before I left the office

Aug 19, 2016
Betadine allergy
by: Anonymous

I am allergic. to betadine a and have been getting shots for macular degeneration for 2 years with pain from extreme to tolerable.

I have found if the assistant washes my eye with lots and
Lots of water about half a bottle there is no pain.

Also I just read 0.1 to 1percent strength solution is just
as effective as 4.5?

May 31, 2016
Horrible reaction to Betadine
by: Anonymous

The injection was painless, however as soon as the numbness wore off it was the most horrible pain I have ever felt in my life! I returned to office next day and after the Dr examined my eye, said it was a reaction to the Betadine. It is now day 5 after the procedure and can say I finally feel better. I need to do the other eye, but am very hesitant to go through this again.

Apr 07, 2016
Eye injection pain
by: Anonymous

I've had 5 injections, some were Lucentis, a couple were steroids. Of all of them, only one hurt and it was extremely painful. Again, as I noted in previous posts, it is not the injection that hurts, it's the anesthetic procedure. I never had any pain when I had the same tech doing the prep work. But when I had a new tech do it, that was when I was in severe pain for 3 days. My eye was swollen nearly shut and it was tearing uncontrollably. It made me reconsider ever having an injection done again. In my case it wasn't the Betadine (although that does sting a bit), it was the ineptitude of the technician. Honestly, she rubbed and rubbed on my eye with a swab like she was rubbing a magic lamp waiting for a genie to pop out! When I went back for the follow up I told my doctor because he was planning to do another injection. I was immediately relieved when he said I could request the technician I wanted. That is exactly what I'll do. If she's unavailable, I'll reschedule. Obviously, the "bad tech" thought if some is good, more is better. What she ended up doing, by pressing too hard, and continuing too long, was severely abrading my cornea.

Feb 27, 2016
by: AnonymouGLORIAs

i CALLED THE NURSE AND SHE SAID I SHOULD RINSE THE EYE AS MUCH AS POSSIBLE THEN USE ARTIFICAL TEARS EVERY HOUR. I will try this next time as the injections have been a god send for the wet macular.

Mar 28, 2014
Saline Rinse helps the Betadine pain
by: Anonymous

I've had my second Lucentis injection, and it was a breeze compared to the pain I felt after the first one! It is my understanding that the Betadine is the culprit.

My physician took the time to really rinse and flush the eye before I left. I couldn't believe the difference it made in the scratching, burning and tearing I felt after the first injection.

The injection didn't was the antiseptic side-effects that was the problem. Flush, flush, flush post injection and Betadine.

Nov 25, 2013
Betadine is the problem
by: Jane

I have had a few injections of Avastin with one doctor and 3 injections of Lucentis with a different doctor due to a move. I had a bad reaction to one of the Avastin injections that lasted a couple days. With the last 2 Lucentis injections...the last one today....I have had a bad reaction. The doctor admits it is the betadine and they cut the amount in half today but I am sitting here with my eye closed to lessen the irritation. I am hoping it will be fine in the morning. My doctor sems to feel it is necessary to use the Betadine but I wish there was an alternative. As noted in one of the other comments, my sinuses are affected and my nostril on the side of the treated eye runs constantly and then gets stuffy. If this drug works and heals my eye, I guess it's worth it but so far I haven't seen enough effect, especially at the cost of the Lucentis.

Jan 23, 2012
Lucentis Treatment for Macular Degeneration
by: Bill

While the world of Retinal Surgeon's are doing quite nicely with this massive "Baby Boomer' eye disease; treatment I have found differs considerably from country to country and doctor to doctor.

My first Lucentis injection was conducted in OKC USA. I had the drops in the eye, sat in the chair for what seemed to be half a day (more likely 45 minutes) the doctor walked in and WA-HAM! The last of the injection, or at least near to the end of the shocking un-blocked pain, I was standing not sitting ! I let him know I would not want my dog receiving that pain level.

With only the one eye, I have been often thankful that there are not two eyes to puncture every 4-5 weeks. Sometimes it was very painful and felt like the doctor had used a needle twice the length of the last. I worked away at making sure I had the correct number of drops, made sure the first self administered drop of Cyclopentolate Hydrochloride went in exactly one hour before the injection etc.

No matter how I behaved or prepared, each shot hurt more, if less it was only slightly less- there appeared no way of having a consistent acceptable pain level. I continued to let my Doctor know he was not consistent. To his credit he has made a vast improvement with the way he administers the Lucentis. He seems to now just prick the eye and I see far less chemical floating by.

Now 54 shots later, I am having the treatment administered with the same and lower pain threshold each time. As I only have one eye, my Doctor conducts the injection in a day surgery theatre environment. Just as I have many people ask, how much does it hurt? I am able to say it is now a comfortable procedure. I can also confirm that others are experiencing the same reduction of pain with improved applications buy their Doctors. Of course the doctors are claiming, nothing has changed! This comment is just nonsense.


Jan 05, 2012
Pain with Ocular Injections
by: Bill Kerr

I've had four injections in my left eye. The first was a kind of struggling torture. The physician said they overloaded me with sedative because it was the first. It felt exactly as you imagine a needle going into your eye. It was a scene from "Marathon Man," ocular version.

The next three were beautifully painless. It was done in Germany in a clinic. We sat in a waiting room while the assistant put in drops at five minute intervals, at least four times before the injections. I think there must be ways to reduce the pain. I didn't ask for which substances were used. A friend complained to me about the disinfectant that was use on him. I don't remember having it, not in the last four injections.

So much depends on the skill and the touch of the physician.

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