Lutein Injectios For Wet Amd

[MichaelZZ]

My wife is currently being treated for wet AMD and over the last 18 months or so has had a total of 10 lutein injections (6 in one eye and 4 in the other). Last Friday she was told that she needed another injection but the doctor who was giving her the injection explained that he was going to use a different device to keep her eye open during the injection. According to my wife, he appeared to be slightly unsure of exactly what he was doing. This doctor has administered the majority of my wife's injections hitherto and the procedure is usually quite slick and efficient. This time he seemed just a bit unsure that the lutein had gone in correctly and asked my wife if she had "seen the bubbles" (She hadn't). He also asked if she had seen it "flood across" (She hadn't). Immediately after previous injections, my wife notices some blurring of vision and as a result normally has to concentrate to see how many fingers the doctor is holding up. This time the number of fingers was quite clear.
At this point my wife expressed her concern that the injection had not gone in correctly so the doctor apparently checked with some other instrument and somewhat off-handedly pronounced everything was "fine".
My wife is firmly of the opinion that, having had 10 injections over recent months, she knows what a "good" injection feels like. This time feels entirely different and she is concerned that the lutein will not do its job because it hasn't gone in. She is reluctant to challenge the doctor but feels that she would like some convincing reassurances. She isn't due for another appointment at the clinic for four weeks and is very anxious that in this time her AMD may progress further because of the "non-injection".
I would appreciate comments from some experienced medical professional as to what the best course of action would be and I would particularly like answers to the following questions:
1. If the injection didn't go into her eye, then where did it go? (It certainly didn't run down her cheek. Could it have somehow gone inside her eye socket? )
2. Is there a quick and definitive way to determine if the injection did go in even though my wife did not see the usual "bubbles" or "flood". I'm thinking here about additional photographs or scans to determine what if any change there has been in the macula since the last set of photos.
3. Is there any point in my wife having another injection before the 4 weeks is up just to "make sure"?
Any comments would be much appreciated.

[MichaelZZ]

^^^
Corrections:

Title should of course read "Lucentis injections ..."
All references to "Lutein" should read "Lucentis"

Sorry for ant confusion.

[Sqad]

My Ophthalmological experience and knowledge is "modest."

York 310 is the ABer that will give you good advice.......

Here are my comments which I hope may be helpful.

It is extremely unlikely that the injection material did not go into the vitreous as this procedure is common in Ophthalmological practice and the doctor had done the procedure on many occasions and on this occasion, the only difference being in technique was one of a different type of retractor.
Again, in expert hands it is extremely unlikely that the material went onto the eye socket,as the needle would have to have missed the eye completely........extremely unlikely.

I do not think it necessary to experience"bubbles" or "flooding" to guarantee a successful site injection.

In the unlikely event of the injection not going into the vitreous, I am sure that the omission of one injection would not give the "green light" to the sudden abnormal growth of annoying blood vessels.

If it was my wife..........I wouldn't worry.

York310 will give a more professional appraisal to your question.

[york310]

As sqad says don't worry.

When they do the injection a small mark is made on the white of the eye where the injection is to be made. There would be no where else for the drug to go other than into the vitreous otherwise the medic would have observed this.
I feel that your wife's experience differed this time more as she felt less confident with the practitioner. Not everyone will see the bubbles but usual vision will change slightly.
There is an extremely low chance that the drug was not administered correctly but obviously your wife felt it was clumsy this time.
I would however voice your concern when you next attend the clinic.

[MichaelZZ]

Thank you very much, Sqad and Yorkie, for your most reassuring words. We just have to wait and see what, if anything, happens between now and her next appointment.