Lauren M Wasser1, Eduardo Roditi2, Adina R Weiss2, Yishay Weill2, Meni Koslowsky3,4, David Zadok2, Joel Hanhart2, Itay Magal2. 1. Department of Ophthalmology, Shaare Zedek Medical Center Affiliated with the Hebrew University - Hadassah School of Medicine, 9103102, Jerusalem, Israel. lauriew21@gmail.com. 2. Department of Ophthalmology, Shaare Zedek Medical Center Affiliated with the Hebrew University - Hadassah School of Medicine, 9103102, Jerusalem, Israel. 3. Departments of Psychology, Ariel University, 44837, Ariel, Israel. 4. Bar-Ilan University, 52900, Ramat Gan, Israel.
Abstract
PURPOSE: This study compared pain and anxiety levels in individuals receiving intravitreal injections (IVIs) using a speculum-free injection technique, the lid splinting eyelid retraction technique, or using a speculum. METHODS: This was a prospective study of individuals receiving IVI at a single tertiary care medical center who responded to a questionnaire and visual analog scale (VAS) between December 2019 and January 2020. In one group, a speculum was used prior to injection, whereas in the other group, a speculum-free injection technique was used. RESULTS: A total of 108 individuals were included in this study: 54 received IVI with the speculum-free lid splinting eyelid retraction technique and 54 received IVI with a speculum. A correlation between pain and anxiety was demonstrated in the control group (p-value < 0.01); however, in the speculum-free group, this correlation was lower and not significant. When comparing pain and anxiety between the study groups, lower median pain (Mood's: Z = 5.378, p-value < 0.001) and lower anxiety (Mood's: Z = 2.108, p-value = 0.035) scores were demonstrated in the speculum-free group than in the control group. The distribution of pain scores was significantly different between the study groups (Kolmogorov-Smirnov: D = 0.518, p-value < 0.001), and trending differences in anxiety between the groups were observed (Kolmogorov-Smirnov: D = 0.259, p-value = 0.053). CONCLUSION: The lid splinting eyelid retraction technique, a speculum-free technique, was associated with less anxiety and pain in patients than the use of a speculum. As IVI often involves repeated treatment, identifying modifiable factors that may relieve anxiety and pain is of utmost importance.
PURPOSE: This study compared pain and anxiety levels in individuals receiving intravitreal injections (IVIs) using a speculum-free injection technique, the lid splinting eyelid retraction technique, or using a speculum. METHODS: This was a prospective study of individuals receiving IVI at a single tertiary care medical center who responded to a questionnaire and visual analog scale (VAS) between December 2019 and January 2020. In one group, a speculum was used prior to injection, whereas in the other group, a speculum-free injection technique was used. RESULTS: A total of 108 individuals were included in this study: 54 received IVI with the speculum-free lid splinting eyelid retraction technique and 54 received IVI with a speculum. A correlation between pain and anxiety was demonstrated in the control group (p-value < 0.01); however, in the speculum-free group, this correlation was lower and not significant. When comparing pain and anxiety between the study groups, lower median pain (Mood's: Z = 5.378, p-value < 0.001) and lower anxiety (Mood's: Z = 2.108, p-value = 0.035) scores were demonstrated in the speculum-free group than in the control group. The distribution of pain scores was significantly different between the study groups (Kolmogorov-Smirnov: D = 0.518, p-value < 0.001), and trending differences in anxiety between the groups were observed (Kolmogorov-Smirnov: D = 0.259, p-value = 0.053). CONCLUSION: The lid splinting eyelid retraction technique, a speculum-free technique, was associated with less anxiety and pain in patients than the use of a speculum. As IVI often involves repeated treatment, identifying modifiable factors that may relieve anxiety and pain is of utmost importance.
Authors: Rahul Chaturvedi; Kendall W Wannamaker; Paul J Riviere; Arshad M Khanani; Charles C Wykoff; Daniel L Chao Journal: Ophthalmol Retina Date: 2019-04-04
Authors: Maurice Theunissen; Madelon L Peters; Julie Bruce; Hans-Fritz Gramke; Marco A Marcus Journal: Clin J Pain Date: 2012 Nov-Dec Impact factor: 3.442