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News
A new meta-analysis suggests that ditching the traditional eyelid speculum during intravitreal injections could mean less pain for patients. Manual eyelid retraction was linked to significantly lower pain scores, while device-assisted techniques cut complication rates roughly in half. Researchers say larger studies are needed before making it the new standard.
Intravitreal injections — shots delivered directly into the eye — are one of the most commonly performed procedures in ophthalmology, and their volume is only growing. The standard approach uses an eyelid speculum to hold the eye open, but a new meta-analysis presented at EURETINA 2026 in Vienna suggests that skipping the speculum could make the experience considerably more comfortable for patients.
The analysis pooled data from 11 studies and 713 patients, comparing two non-speculum techniques — manual eyelid retraction with a cotton-tip swab and device-assisted retraction — against the conventional speculum method. Manual retraction came out ahead on pain, showing a statistically significant reduction in patient-reported discomfort. Device-assisted approaches, meanwhile, were associated with roughly half the complication rate of speculum-based injections, though they didn't show a clear pain advantage.
Key Takeaways:
Why it matters: With injection volumes at major centers projected to nearly double by 2029, even modest improvements in patient comfort and safety could have an outsized real-world impact — especially for patients receiving repeated injections over many years.
