8 Ways to Ease Anxiety Before an Eye Injection for Diabetic Macular Edema

No one really looks forward to getting a shot - and when you're living with diabetic macular edema (DME) and about to get a shot in the eye, you may be feeling even more hesitant about going to the doctor.

Research shows that about half the people who have DME feel some anxiety or fear about receiving eye injections.

And, as understandable as that may be, there are very good reasons not to let that fear stop you from receiving treatment. These anti-VEGF (vascular endothelial growth factor) injections - which help prevent the growth of new blood vessels in the eye, thereby helping to restore vision - are one of the best medications available for treating DME.

The catch: They need to be administered consistently, usually once a month for the first couple of doses. Some research shows that delaying an injection by even a week is enough to worsen a person's DME - for example, by causing a buildup of fluid in the eye or other changes.

"Without treatment, the disease often starts to become active again … which can lead to permanent vision loss," says Sunir Garg, MD , a spokesperson for the American Academy of Ophthalmology and a professor of ophthalmology at WillsEye Hospital in Philadelphia.

8 Ways to Ease Your Eye Injection Fears

Scheduling the injection appointment and sitting in that doctor's chair can be a daunting feat. If you're still feeling anxious, these tips can help take the sting out of the shot.

1. Learn about the injection procedure. It's expected that you'll feel very little pain, if any at all. You'll likely be given numbing drops or gel so the injection won't hurt, and you'll be looking away while the needle is inserted - so you'll feel more prepared and knowledgeable about the process.
   "Our topical anesthetics, or numbing drops, are really amazing, and for about half of patients, it's really not such a big deal," says Dr. Garg. Your eye doctor wants you to feel comfortable, too - so if you're feeling nervous, speak up. "Usually, we can help talk a patient through it," says Garg. Before your injection, your doctor can tell you exactly what you can expect during it.
2. Talk to people who have been there. Your doctor is a great resource if you want to learn about the procedure itself, but turn to other people with DME for their firsthand experiences. If you don't have anyone in your personal life also going through treatment for DME, seek out support groups or online communities .
3. Don't lose sight of why you're getting the injection. Left untreated, DME can result in permanent vision loss. Remind yourself that these injections can improve your sight in order to ease any fears or hesitations you may have about sitting in that doctor's chair. "It's one of the main things [that can] help people improve their lives," says Garg.

4. Don't go it alone. Ask a family member or friend to come with you to your appointment to give you some extra comfort and support.
   Sometimes loved ones aren't allowed in the actual procedure room, so if you aren't able to bring someone in with you, ask the technician or other staff member to hold your hand.

5. Practice relaxation techniques. To ease the physical and mental tension you may feel before or during your appointment, try doing relaxation exercises such as visualization, meditation, or deep breathing.

6. Bring something to distract you. Having something else to focus on during the procedure may help you feel less anxious. Throw on your favorite podcast or listen to an audiobook. Music can be particularly soothing, so ask your eye doctor if you can listen to some relaxing songs on your earbuds. You can also bring a stress ball to squeeze while they are administering the injection.

7. Consider anti-anxiety medication or other therapies. If you're feeling so overwhelmed with anxiety about receiving an injection that you may not go through with it, it might be worth talking to your primary care doctor or a psychiatrist, who may be able to prescribe you anti-anxiety medication.
   You could also consider cognitive behavioral therapy to ease fears around intravitreal injections.

8. Know that you are in control. Your treatment experience is just that - yours . It's ultimately up to you how you'll prepare yourself best for injection days. Talk to your doctor about what would make you feel most comfortable during the procedure, whether that's music and medication or a simple verbal warning before the needle is inserted into your eye.

The Takeaway

Anti-VEGF injections are a key treatment for diabetic macular edema, and anxiety about this procedure is not uncommon. Once you know that these injections can help preserve your vision, you can work on staying relaxed before and during your appointment. Bring a loved one along if you want and practice relaxation techniques to keep your mind at ease during your injection appointments.

Resources We Trust

• Mayo Clinic: Diabetes-Related Macular Edema: Answers to Your Most Common Questions
• Cleveland Clinic: Diabetes-Related Macular Edema
• National Eye Institute: Injections to Treat Eye Conditions

More in Diabetic Macular Edema

What to Know About Diabetic Macular Edema

How Well Are You Managing DME?

7 Ways to Slow the Progression of Diabetic Macular Edema

What You Need to Know About Early Onset Diabetic Macular Edema

Editorial Sources and Fact-Checking

Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy . We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.

Sources

1. Giocanti-Auregan A et al. Drivers of and Barriers to Adherence to Neovascular Age-Related Macular Degeneration and Diabetic Macular Edema Treatment Management Plans: A Multi-National Qualitative Study. Patient Preference and Adherence . March 3, 2022.
2. Diabetes-Related Macular Edema. Cleveland Clinic . February 14, 2023.
3. Navarrete A et al. The Detrimental Effects of Delayed Intravitreal Anti-VEGF Therapy for Treating Retinal Pathology: Lessons From a Force Test-Case. Graefe's Archive for Clinical and Experimental Ophthalmology . January 7, 2022.
4. Intravitreal Injections. American Society of Retina Specialists .
5. Needle Fears and Phobia. Centers for Disease Control and Prevention . July 27, 2023.
6. Gomez J et al. Strategies for Improving Patient Comfort During Intravitreal Injections: Results From a Survey-Based Study. Ophthalmology and Therapy . December 5, 2016.
7. Relaxation Techniques: Try These Steps to Lower Stress. Mayo Clinic . January 24, 2024.
8. Ozaki A et al. Efficacy of Psychiatric Treatment to Treat a Specific Phobia of Intravitreal Injections in a Patient With Neovascular Age-Related Macular Degeneration. Case Reports in Ophthalmology . January–April 2021.

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Angela D. Harper, MD, is in private practice at Columbia Psychiatric Associates in South Carolina, where she provides evaluations, medication management, and psychotherapy for adults.

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