Cotton-tip applicator lid retraction technique for controlled intravitreal injection.

Cotton-Tip Applicator Lid Retraction Technique for Controlled Intravitreal Injection Intravitreal injection of anti-vascular endothelial growth factor agents for retinal, vascular, and macular disease has become one of the most commonly performed medical procedures worldwide. Safety, cost, and patient comfort issues are thus of huge importance. The majority of retina specialists uses a lid speculum, although it may be associated with significant patient discomfort as it stretches the medial and lateral canthi. Only upper lid retraction with a metal hemispeculum (Desmarres) has been recently tried. A bimanual “twoperson” injection method has been presented as well. An alternative technique is presented here.