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A novel device for rapid, safe and precise delivery of intravitreal injections
  1. Salman Waqar1,
  2. Ali Ayaz2,
  3. Irfan Karamat2,
  4. Saba Anwar2,
  5. James McLeod3,
  6. Alan McLeod4
  1. 1 Royal Eye Infirmary, Plymouth, UK
  2. 2 Department of Ophthalmology, King Edward Medical University, Lahore, Pakistan
  3. 3 Department of Bioengineering, Imperial University, London, UK
  4. 4 Health Innovation Support Ltd, Muchelney, UK
  1. Correspondence to Mr Salman Waqar, Royal Eye Infirmary, Plymouth PL68DH, UK; salman.waqar{at}


Background Delivery of therapeutic agents via intravitreal (IVT) injections is well established as the mainstay of treatment for many ophthalmic conditions. High demand means that injections are increasingly being delivered either by ophthalmic nurse practitioners (UK) or by ophthalmologists in office-based settings (North America/mainland Europe). Most patients require frequent IVT injections, and there is a need to make the procedure more comfortable and safe.

Methods We describe a novel device designed to ensure rapid, safe and precise delivery of injections while improving the patient experience. In addition, we present details of a local National Health Service pathway initiated to facilitate clinician-led innovations. It is hoped that this model can also be replicated internationally. We also present results from two sites: one, comparing outcomes of 25 patients who received the injection with the device, against 25 patients who received injections using the current standard method; the other a retrospective notes evaluation of 60 patients injected with the device.

Results No adverse events were noted and the device appears to be well tolerated by patients. Use of the guide did not result in a statistically significant increase in pain (p value > 0.05) but the mean score (on a unidimensional numerical rating scale) was noted to be slightly better. All patients gave very positive informal feedback.

Conclusions We have described the design process and successful early-use results of a novel device developed to facilitate safe, precise and rapid delivery of IVT injections by both ophthalmologists and allied health professionals.

  • intravitreal injections
  • ophthalmology
  • patient safety
  • innovation
  • National Health Service

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  • Contributors SW designed the instrument and conducted the study in Plymouth. AA, IK and SA designed, collected data and analysed the study in Lahore. JL and AL designed the instrument.

  • Competing interests Salman Waqar’s employer (University Hospitals Plymouth NHS Trust) is in a revenue share agreement with the manufacturer of the device (Beaver-Visitec International).

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement All data relevant to the study are included in the article or uploaded as supplementary information.