Improving Patient Comfort During Intravitreal Injections: Anesthesia Strategies in Retina Practice

Intravitreal injections (IVI) are among the most frequently performed ophthalmic procedures, often requiring repeated administration for chronic retinal diseases. As treatment burden increases, the patient experience, encompassing procedural comfort, anxiety, trust in the care team, and emotional engagement with long-term therapy, has emerged as an important consideration in modern retina practice. Ocular anesthesia plays a central role in minimizing pain and may help reduce anxiety and support adherence to therapy. This article examines ocular anesthesia techniques used in intravitreal therapy through a patient-experience lens, with a focus on patient-reported comfort, procedural efficiency, and clinical safety. Current techniques include topical anesthetic drops, gels, anesthetic-soaked pledgets, and less commonly, subconjunctival injections or regional blocks. Current literature has not identified a single superior technique, which highlights the importance of individualized, patient-centered selection based on comfort, anxiety, and prior experience. We propose a patient-centered framework that integrates expectations, communication, feedback, and we identify gaps in current knowledge and priorities for future research. Continued emphasis on patient experience, alongside well-tolerated and practical anesthetic options, may support adherence to long-term therapy and optimize outcomes in retinal disease management.