Intravitreal injections are shots of medicine that go into ("intra-") the eye ball and directly into the vitreous cavity ("vitreal"), the innermost part of the eyeball. There are two main categories of shots: 1) steroids; and 2) Anti-Vascular Endothelial Growth Factor (VEGF) agents. Steroids work best when the eye is inflamed - inflammation is usually transient and can happen within a year or two after radiation treatment. Inflammation usually is accompanied by aching pain of the eye and of the tissues surrounding the eye, like the eyelid, temple or forehead. Inflammatory pain is usually worse at the end of the day, and responds well to topical steroid eye drops, like prednisolone acetate 1%. Performing the fluorescein angiogram (the dye test that assesses the retinal circulation) will reveal leaking vessels throughout the entire retina, and especially the optic nerve and macula. This offers objective evidence for inflammation. When these various conditions are present, giving steroid eye drops or even peri-ocular (ie, around the eye) steroid injections may be very helpful with symptoms.  Radiation retinopathy, on the other hand, does NOT respond much if at all, to steroids - whether they be drops or shots into the eye (intravitreal steroids). This has been previously published in several papers by the Shields group in the mid-2000s. Anti-VEGF agents include all of the following trade name drugs: Avastin, Eylea, Lucentis, Vabysmo, Eylea HD and more are likely to come on the market, all originally intended for the disease, age-related macular degeneration. They are very helpful for people who develop radiation retinopathy, and in particular in those with early symptoms of blurred central vision with their radiation retinopathy. Any and all of these intravitreal drugs will be helpful. Not all eyes develop radiation retinopathy, therefore, not everyone needs these shots. People who notice that these anti-VEGF shots are not offering any improvement to their vision, may discontinue anti-VEGFs shots. ** The eye will not die and/or proceed to blindness if anti-VEGF shots are stopped. ** Welcome to Finding Your Way with Ocular Melanoma, a guide to understanding everything there is to know about your experience with this rare cancer. Learn through the lens of my knowledge and clinical experience as a physician expert and passionate patient advocate. The more you know about ocular melanoma, the better you will do, and the better you will live. Let's go! The content shared on the Finding Your Way with Ocular Melanoma podcast is for informational and educational purposes only and does not constitute medical advice. The information provided must not be used as a substitute for professional medical advice, diagnosis, or treatment. As a listener, you are responsible for your own health-related decisions and must consider consulting with a healthcare professional for personalized medical advice.  Tara McCannel MD PhD is a an ocular oncologist, vitreoretinal surgeon and co-founder of Seyhart Wellness. She is also the host of the Mind Body MD podcast where she shares her passion for holistic health and wellness.

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