Protecting Vision with Intravitreal Therapy
Intravitreal Injection of Lucentis, Eylea, Vabysmo & Ozurdex in Singapore
Dr Bobby Cheng provides intravitreal injection therapies in Singapore — including Lucentis, Eylea, Vabysmo, and Ozurdex — tailored to each patient’s diagnosis and treatment needs.
Medically reviewed by Dr Bobby Cheng
Senior Consultant Ophthalmologist
MBBS (Singapore) | MMed (Ophthalmology, Gold Medal) | FRCS (Edinburgh) | FAMS
What Are Intravitreal Injections?
An intravitreal injection delivers medication directly into the vitreous cavity — the gel-filled space behind the lens of the eye. This targeted approach allows high concentrations of therapeutic agents to reach the retina precisely where treatment is needed, making it highly effective for conditions such as macular degeneration, macular swelling, and abnormal blood vessel growth that can threaten vision.
The procedure is quick and minimally invasive, performed under anaesthetic eye drops in the clinic or as a day surgery procedure in the hospital depending on individual clinical needs. Most patients tolerate it well and are able to return home shortly after the injection.
Medication Options
Lucentis (Ranibizumab) is a widely used anti-VEGF (vascular endothelial growth factor) therapy administered directly into the eye to treat a range of retinal conditions driven by abnormal blood vessel growth or vascular leakage. As one of the original and most clinically studied anti-VEGF agents, Lucentis has an extensive evidence base supporting its safety and efficacy across multiple retinal disease indications.
Conditions Treated with Lucentis
- Wet age-related macular degeneration (AMD)
- Diabetic macular oedema (DME)
- Retinal vein occlusion (RVO)
- Myopic choroidal neovascularisation (mCNV)
How Lucentis Works
Lucentis works by blocking vascular endothelial growth factor (VEGF) — a protein that drives abnormal blood vessel formation and causes fluid to leak beneath the retina. By inhibiting VEGF, Lucentis reduces retinal swelling, halts further vision loss, and in many cases helps to maintain or improve central vision.
Treatment Course
Treatment typically begins with a loading phase of monthly intravitreal injections to achieve rapid disease control and establish a baseline response. Once the retina stabilises — usually after two to three months of monthly treatment — a treat-and-extend protocol is adopted. Injection intervals are progressively extended based on OCT imaging and clinical assessment, allowing treatment to be personalised to each patient’s individual response. Dr Bobby Cheng will determine the most appropriate dosing schedule based on how your eye responds to treatment.
Eylea (Aflibercept) is a leading anti-VEGF (vascular endothelial growth factor) therapy used in the treatment of sight-threatening retinal conditions characterised by abnormal blood vessel growth and retinal fluid leakage. As one of the most extensively studied and widely administered intravitreal agents globally, Eylea has demonstrated strong and durable efficacy across its approved indications — making it a cornerstone of modern retinal disease management.
Conditions Treated with Eylea
- Wet age-related macular degeneration (AMD)
- Diabetic macular oedema (DME)
- Retinal vein occlusion (RVO)
How Eylea Works
Eylea works by blocking vascular endothelial growth factor (VEGF) — the protein responsible for stimulating abnormal blood vessel growth and causing fluid to leak into the retina. By inhibiting VEGF, Eylea reduces retinal swelling, stabilises vision, and in many patients helps to preserve or improve central visual acuity.
Eylea acts as a soluble decoy receptor, binding VEGF with high affinity — an important characteristic that contributes to its efficacy and durability between treatment intervals.
Treatment Course
Eylea treatment is initiated with a loading phase of monthly intravitreal injections — typically for the first two to three months — to achieve rapid suppression of disease activity and establish retinal stability. Following the loading phase, a treat-and-extend protocol is employed: injection intervals are progressively lengthened based on OCT imaging findings and clinical response. Dr Bobby Cheng will guide the frequency of your injections, reducing clinic visits over time while maintaining effective disease control. Some patients with wet AMD may be eligible for extended dosing intervals of up to 12 or 16 weeks with the higher-dose Eylea HD formulation.
Vabysmo (Faricimab) represents a significant advancement in intravitreal therapy — the first bispecific antibody approved for the treatment of retinal disease. Unlike conventional anti-VEGF agents that block a single molecular target, Vabysmo is engineered to simultaneously inhibit two distinct pathways that drive retinal vascular instability and fluid leakage: vascular endothelial growth factor (VEGF) and angiopoietin-2 (Ang-2).
Conditions Treated with Vabysmo
- Wet age-related macular degeneration (AMD)
- Diabetic macular oedema (DME)
How Vabysmo Works
Unlike conventional anti-VEGF agents that target a single pathway, Vabysmo simultaneously blocks two key drivers of retinal vascular disease: vascular endothelial growth factor (VEGF) and angiopoietin-2 (Ang-2). While VEGF promotes abnormal vessel growth and leakage, Ang-2 destabilises blood vessel walls and amplifies the effects of VEGF. By targeting both pathways, Vabysmo addresses the disease more comprehensively — helping to stabilise retinal blood vessels, reduce fluid leakage, and decrease macular swelling more effectively than VEGF inhibition alone.
This dual blockade may allow some patients to achieve longer intervals between injections while maintaining effective disease control.
Treatment Course
Vabysmo treatment is initiated with four consecutive monthly injections to establish rapid and robust disease suppression. Following this loading phase, dosing intervals are personalised based on OCT imaging findings and clinical assessment — extending progressively to every 8, 12, or 16 weeks depending on individual treatment response. Dr Bobby Cheng will work with you to determine the most suitable long-term dosing schedule, making Vabysmo a particularly attractive option for patients seeking effective disease management with a reduced injection frequency.
Ozurdex is a biodegradable sustained-release intravitreal implant containing dexamethasone — a potent corticosteroid — that is injected directly into the vitreous cavity of the eye. It represents a distinct therapeutic approach compared to anti-VEGF agents such as Eylea and Vabysmo: rather than blocking vascular growth factors, Ozurdex targets the inflammatory pathways that underlie retinal swelling and fluid accumulation, offering an important complementary or alternative treatment option for selected patients.
Conditions Treated with Ozurdex
- Diabetic macular oedema (DME)
- Retinal vein occlusion (RVO) — both branch (BRVO) and central (CRVO)
- Non-infectious uveitis affecting the posterior segment of the eye
How Ozurdex Works
Once inserted into the vitreous cavity, the implant releases dexamethasone in a controlled and sustained manner, directly targeting the inflammatory processes that drive retinal swelling. By suppressing inflammation at the source, Ozurdex reduces macular oedema and helps to stabilise or improve vision. The implant is biodegradable and dissolves gradually over time — no removal procedure is required.
Treatment Course
A single Ozurdex implant provides sustained therapeutic effect for approximately three to six months, after which its activity gradually diminishes as the implant dissolves. The need for re-treatment is assessed based on clinical response, OCT imaging findings, and the recurrence of macular oedema. Dr Bobby Cheng will monitor your eye regularly and advise on the optimal timing for re-treatment, while proactively managing potential steroid-related side effects — including raised intraocular pressure and cataract progression — as part of your ongoing care.
If you have been diagnosed with wet AMD, diabetic macular oedema, or retinal vein occlusion, timely intravitreal injection therapy can help protect your sight.
We provide personalised intravitreal injection therapy in Singapore, with ongoing monitoring to adjust treatment as your condition evolves.
What to Expect During an Intravitreal Injection Procedure
Many patients feel understandably apprehensive about the prospect of an injection into the eye. In practice, intravitreal injections are a well-tolerated, routine procedure that takes only a few minutes and causes minimal discomfort for the majority of patients. Here is what to expect at each stage:
Anaesthetic Eye Drops
Drops are applied to numb the surface of the eye, ensuring comfort throughout the procedure.
Eye Cleaning
The eye and surrounding area are carefully cleaned with antiseptic solution to minimise the risk of infection.
Injection
The medication — Lucentis, Eylea, Vabysmo, or Ozurdex — is delivered through a very fine needle into the vitreous cavity of the eye. The process is precise and takes only a matter of seconds.
Discharge
The entire procedure typically takes only a few minutes from start to finish. Most patients are able to return home shortly after and resume normal daily activities the same day.
Frequently Asked Questions About Intravitreal Injections
Most patients experience only mild pressure during the injection rather than pain. Anaesthetic eye drops are applied beforehand to numb the surface of the eye, and the procedure itself takes only a few seconds. Any temporary discomfort following the injection typically resolves quickly.
Injection frequency varies depending on the condition being treated and how your eye responds to therapy. Most patients begin with a loading phase of monthly injections to establish disease control. Dr Bobby Cheng will then assess your response and transition to a personalised treat-and-extend schedule, gradually spacing injections further apart while maintaining close monitoring.
Intravitreal injections do not cure retinal diseases. However, they are highly effective at controlling disease activity, reducing retinal swelling, and preserving — or in some cases improving — central vision. Long-term monitoring and ongoing treatment are an important part of managing these conditions effectively.
Most patients return home and resume normal daily activities on the same day. You may be advised to avoid strenuous exercise or swimming for 24 hours following the injection. We will provide specific post-injection care instructions based on your individual treatment plan.