Painful Eye Injections - Betadine the Cause?

by Susan
(St. Louis)

Leslie,

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?

REPLY

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

Comments for Painful Eye Injections - Betadine the Cause?

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Aug 09, 2021
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Alternative to betadine
by: Myrna

See these studies for an alternative to the betadine:

https://clinicaltrials.gov/ct2/show/NCT04018482

https://www.researchgate.net/publication/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7774204/

I have hd the IV injections with the Avenova prep it was wonderful I could have driven home. NO pain

Apr 17, 2021
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betadine problems
by: Anonymous

Obviously the betadine is a huge problem to a lot of people. They need to find a better solution to it. I went 4 years before I suddenly started having problems with it. My doctor does not swab around the eye with it. He only puts it on the shot spot. I can't imagine having it all over around the eye to add to the problem. I would think they could use a better option for cleansing around the eye & only use the betadine in the eye for the shot. Mine just dabs the shot spot. I now put a patch on the eye after which helps stop the eye rubbing on the lid & have had no problems since doing this. My eye has improved from my shots but the horrible pain from the betadine does make one think about quitting. From all I have read over time I don't think some doctors are very helpful.

Apr 13, 2021
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Help from gel drops
by: Fire in the eye!

Today was injection day. And the first time the suggestion has been made that I try Refresh Celluvisc Preservative-Free Gel drops in place of my everyday Systane preservative-free drops. Though Systane will probably be my go-to everyday drops, these Celluvisc drops have been amazing to knock down the post injection Betadine burn that seems to go on for hours. Sure, my eye is still sore, but the fire is finally under control. There is such a significant difference in the amount of soothe provided, I hope this information will bless you all as much as it is right now blessing me.

Here’s to our best vision ever, with the least amount of pain!
Blessings all!

Feb 20, 2021
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Severe betadine pain also
by: Caryl

I had no pain after the first couple years after my eylea shots. Then suddenly after my shot it was terrible for at least 12 hours. My doctor says he hasn't changed the procedure. He uses a swab to put the betadine only where he is going to give the shot. This last time he said the eye movement is irritating it so he put a patch on my eye so I had to keep it closed till the next day. I had no pain. Will do the same next time to test it again. I wish they would find a betadine replacement. So many people suffer from it.

Dec 18, 2020
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Serious Pain after eye injections
by: AnonymousLD

It was a relief to read the many reports of pain after AMD injections. I have had about 40 of these and the after effects seem to be getting worse! This last time it was horrendous!

I find it OK having the jab but after a couple of hours when the anaesthetic wears off, the pain is intense. This time I couldn't open my eyes which were streaming, along with my nose! I had to go to bed and took cocodomol as often as allowed. I was not able to open my eyes until the next morning and two days later my eye is still red and swollen.

Feb 01, 2020
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Betadine prep reaction
by: Nancy Caul

I too suffered with extreme eye irritation and weeping after my injections. First told it had to do with allergies. Went to a specialist who confirmed even with labs, that I have no allergies. I was referred to a different eye specialist.

He flipped my lids and said I had blisters under my eyelids. I stayed on prednisone several months. It only helped while on the med. Did more tests, then the doctor determined it was the betadine prep solution.

Thankfully my Retina specialist allowed me to use antibiotic drops before and after my injections. My injections are every 5 weeks, in my right eye.
I have a video of my eyes, (yes, both eyes reacted) after the last injection using the betadine prep. I wish I could post.

It was so serious and took over a year to determine it was the betadine prep. Keep in mind I am not allergic to iodine either.
I hope my experiences may help anyone else dealing with this situation.

Feb 01, 2020
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Dilation & Allergy drops
by: Susan St Louis

Thanks to the reviewer (Fire in the eye!) who posted that Alaway allergy drops helped the pain after receiving betadine in her eye for an injection.

I also want to reiterate what she said about using a weaker drop for dilation. I have light green eyes and my eyes dilate very easily. I started asking for the lighter dilation 3 or 4 years ago.

My doctor has no problem seeing the back of my retina. So now instead of being dilated and sensitive to light for almost 72 hours, the dilation lasts less than 24 hours and I can almost bear sunlight after 8 hours. My eye is especially sensitive to light after an injection so this has helped make the injection a little more bearable!

Jul 13, 2019
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Eylea Injections
by: Shirley

Just had my 3rd injection for wet macular degeneration and every time I come home with eye hurting and burning. The next day my eyelid is swollen and the corner of my eye is crusty and burns like salt has been put in it.

I had no idea what it was until I ran onto this site. Betadine...Its on my meds list. I am allergic to betadine and my surgeon told me never to use it again after I blistered up and major sores after my hip replacement.

So it looks as though I will have a talk with my doctor next visit about betadine. Thanks for sharing. Most helpful.

Jun 28, 2019
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Alaway allergy drops help decrease betadine pain from eye injections
by: Fire in the eye!

Continuing to receive Avastin injections every 6 weeks or so, and knowing I do react horribly to Betadine, the thought dawned on me after a recent injection that perhaps an allergy drop would help when I got home. A call back to the doc’s office confirmed it was ok. It did help, cutting the discomfort significantly, so I use it each time now. I had tried oral Benadryl with no real relief.

I have learned that I must advocate for myself each time I go in for injections. They see so many patients I cannot assume they will remember every detail on my special prep,and with so many helpers from visit to visit. With having blue eyes I ask for half strength dilation drops.

My eyes are sensitive anyway, and half strength seems to dilate them enough for my doctor to examine the back and inside of my eye ok. He is ok with that. Rarely do I need full strength, but I am sure each time to ask for the half strength.

Less time for pupils to return to normal, too.
Then before betadine prep, especially with someone new to me, I remind them of my sensitivity to Betadine. The same goes for the Betadine drops the gals want to put in my eyes before doctor comes in. If they are insistent this is mandatory I politely refuse and ask for the doctor. That usually takes care of the issue. Doctor instills half strength Betadine drops just before injection, then lots of flushing out afterwards.

I still have reaction, but it is better than the full strength full protocol of before. Then lots of Systane drops when I get home and the one Alaway allergy drop (see instructions on bottle). I use Systane drops frequently for dry eye, and they are soothing. I still feel out of commission for the day, but at least it’s a less painful out of commission than before!

Jun 07, 2019
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Allergy to Betadine
by: Anonymous

I’ve been receiving Eylea injections for several years and recently developed an acute allergy to Betadine. After one injection I suffered a severe cornea abrasion. Unbelievable pain!


Now my Dr uses a q tip to spot apply the betadine. I still suffer pain post injection for 2 to 3 days after. This is like torture!

Apr 16, 2019
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Avastin for Wet Macular Degeneration
by: Donna

I have wet macular degeneration and have been on the eye injection shots for 3 yrs now. Never had a problem until YESTERDAY with my right eye injection.

After the shot my Dr.said see you in 10 weeks and she was out the door as usual but witin a minute or two I had such a burning in my eye like never before. The tech flushed out my eye for a good 5 minutes which made it feel better but my eye was watering for several hours afterwards and started burning again for a few minutes in the evening,but the settled down finally.

Went to bed and when I woke up my eye was very red and my eyelid was swollen. All of this was such a different reaction then I have ever had with an injection.

A little scary for me. Called the nurse and she advised me on what was going on but she did mention Betadine possibly being left on there too long before the Dr. was able to come in and give me my shot.

I"m worried now about my next injection?? It's kind of like being hurt by the dentist, it makes you afraid, as if a needle in the eye isn"t enough of a scary thing. I"m really dreading my next visit.

Jun 22, 2018
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It Definitely is the Betadine!
by: Anonymous

I just began my third year of injections of Lucentis for my Retinal Vein Occlusion. The first two years weren't bad. I think the thought of having a needle in the eye was worse than the actual experience!

But then my doctor's practice began a new protocol requiring the use of betadine! Talk about PAIN! I had burns all around my eye and my eye watered non-stop and my vision was blurry for 5 days. It hurt like hell. I did snap a photo, which I showed my doctor so he'd know I wasn't exaggerating. Now he uses very little betadine and after the shot it is immediately wiped off of my face and my eye is thoroughly flushed. I still hurt for a day, but it's better than it was! I also had the words "betadine sensitivity" added to all my health and pharmacy records!

Jun 06, 2018
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96.5 year old doing better
by: Anonymous

Went back to original eye clinic and my mom had zero pain after minimal betadine with good flushing afterward:) Yay!

May 02, 2018
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Use of sponge before injection?
by: Anonymous

I cannot tolerate the sponge so my Doctor gives me an injection before the Avastin injection. Does anyone else have this or do most get the sponge? I also have non stop runny eye and sinus blockage after injection. Wondering if Betadine is in that sponge?

Apr 28, 2018
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Stop the eye pain
by: Anonymous

I asked my eye doctor to use minimal betadine before my injection 2 days ago. And then asked him to flush the eye out really well. NO PAIN following this injection. I couldn't believe it. My previous injection I was in so much pain for two days I was in tears. SO.......MINIMAL BETADINE BEFORE INJECTION AND FLUSHING THE EYE BALL AFTER IS THE REMEDY!!!! I am so glad I found this site.

Apr 24, 2018
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Betadine
by: Nancy

I am so thankful to have found this page. I have been getting eye injections for 18 months. Suddenly after removing scar tissue from the left eye, both eyes became swollen,itchy, tearing, etc. Put on Prednisone drops periodically for 6 months. Went to several specialists. The current one suggested it may be the betadine. I have been in the process of being weaned off the steriods. Had injection today, and both eyes were reactive to the betadine. I have been going to numerous specialists, (even complete allergy workup, which was negative) to finally get to the bottom of this problem. Praying changes can be made for eye prep before my next injection.

Apr 23, 2018
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Extreme Pain with Eye Injections
by: Anonymous

First 3 injections resulted in painful, swollen and red eye and eye area .. Pure agony and I woke to crying, loud prayers for her eye to stop hurting at 3-4 am after the injection the previous afternoon.
Eye surgeon looked at the photos I took of her eye and he only put one drop in from next visit on.

Fast forward to new doctor closer to home, same clinic- different location. First injection was fine- no pain afterward. Today- Second visit to new doctor, extreme pain because he put a 1/2 dose of betadine in, saying it’s better than risking losing her sight to an eye infection. I’m so mad at myself for allowing him to 1/2 dose my poor 96 year old mom instead of giving one drop!
Grrr
Back to former doctor next month! Grrr
And he just called me ( because I callled the after-hours on-call doctor) saying she probably rubbed it! Grrr
Did I say grrr?

Feb 21, 2018
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OMG
by: Anonymous

I am grateful to have found this site. I was out of commission for 12 hours after my last injection. I am on my second doctor and the experiences are vastly different. I used to be able to go right back to work and now I have to have my husband drive me to and from the appointment and I go home into a dark room.

I have been trying to figure out why the difference between doctors and now I realize it is the amount of betadine my current doctor uses plus the fact he won't rinse. I can't take it and am going to point this out. It is bad enough to have a needle stuck in your eye but to have your eye be a gritty, burning mess is unacceptable. Thank you everyone.

Jan 05, 2018
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I Just Walked Out Today
by: Anonymous

After 16 months of monthly injections, with the after-effects getting ever-worse (stick in the eye feeling for 36 hours) I told them I was allergic to betadine, so the doc used an antibiotic drop. That worked great for two months;I felt just fine afterward.

Today, the prep nurse stated the new protocol requires betadine. Recalling my 3am debate with myself about heading to the ER after the last betadine treatment. I declined. They insisted. I left. Now looking for an Arizona doc with a different approach.

Nov 08, 2017
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Aqueous Chlorhexidine
by: JohnP

I have experienced the same issues with my injections over the past 3 yrs, (teary, sensitive, itchy eyes) and would normally hole up in a dark room with eye drops until yesterday's injection appointment.

I was pleasantly surprised to find out that one of the 3 ophthalmologist I see did some research and found that a form of chlorhexidine is a less painful antiseptic than betadine. I was driving after my sister brought me back home, kudos Dr Nelson.

Nov 07, 2017
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Yep Betadine A Problem for Me
by: rae

Finally my doc stopped using the betadine. I'm not pleased it took him so long to give this up. I'm wondering if he was doing a "test" and I was in the "betadine group". It did help if they did a more thorough rinsing of my eye. I also wonder about costs: the betadine did have a purpose of disinfecting the eye & preventing infections. So is the alternative substance more costly?

Oct 23, 2017
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Half Strength Betadine Helps
by: Fire in the eye!

Since my post of June 2017, and a bit of online research, a couple of chats with my doctor, and a healthy dose of prayer, my doctor has agreed to use half strength Betadine, 2 drops right before injection, then copious amount of rinsing after. The tech also preps the eye very carefully avoiding the inner corner so Betadine does not leak under the lids and start the burn. This has worked well for my last injection with some post prep discomfort, but is a tremendous improvement over other prep experiences. I know this problem has weighed heavily on my doctor’s heart and mind...I am so thankful to have had a more tolerable experience!

I also wear no makeup on my lids or lashes before the injection, and try to be sure my skin is well cleansed. I use Avenova Lid Cleanser that was previously prescribed for a different issue.

Oct 22, 2017
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One Drop of Betadine = Only One Hour of Burning
by: Anonymous

I am in my 8th year of eye injections for macular degeneration. I am sensitive to Betadine. I would have to use eye packs from Tues through Sat. because my eye, eyelids etc. were blistered. I have talked my doctor into one drop in the eye before the shot and that is all. Lots of rinsing and numbing drops follow. I am now doing fine. My doctor swore my eye would get infected but it has not. My life is now much better.

brpitt@gmail.com

Oct 18, 2017
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Please No Betadine
by: Anonymous

I have had injections in both eyes for 3 years. I have severe pain in both eyes after the procedure. It feels as though someone has thrown sand in my eyes. I told my Dr. and tech about the pain, eyes watering non-stop and unable to sleep due to pain. He continues to use betadine wash which I know is the culprit! My sister told me her Dr. said there were two other antiseptics they could use! Wish my Dr. would try something else, my pain lasts 48 hrs. Find something else for us PLEASE!!

Aug 30, 2017
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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
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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
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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)...no 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
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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
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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
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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
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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
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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?
Gloria

May 31, 2016
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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
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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
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PAINFUL AFTER INJECTION
by: AnonymouGLORIAs

fIRST TWO INJECTIONS WERE TOLERABLE BUT THE 3RD WAS SOMEWHAT PAINFUL. I HAD THE 4TH 4 DAYS AGO AND THE PAIN WAS A 10.
IT IS THE BETADINE IM SURE.
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
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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 hurt....it was the antiseptic side-effects that was the problem. Flush, flush, flush post injection and Betadine.

Nov 25, 2013
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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
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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.

Bill

Jan 05, 2012
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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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