The Royal Australian and New Zealand College of Ophthalmologists

Recommendations from the Royal Australian & New Zealand College of Ophthalmologists on visual fields, vitamins, alpha-1 blockers, intravitreal injections & retinal detachment. The Royal Australian and New Zealand College of Ophthalmologists (RANZCO) is the leading medical eye specialist organisation in Australia and New Zealand. RANZCO’s mission is to drive improvements in eye health care through continuing exceptional training, education, research and advocacy.

Do not use topical antibiotics pre or post intravitreal injections.

Date reviewed: 27 October 2022

Topical antibiotics (either before or after intravitreal injection) have not been found to decrease the risk of endophthalmitis.

Supporting evidence
  • Hunyor, A. P., Merani, R., Darbar, A., Korobelnik, J., lanzetta, P., & Okada, A. A. (2017). Topical antibiotics and intravitreal injections. Acta ophthalmologica, 96(5), 435-441.
  • Cheung Csy; Wong Awt, Kertes Pj, Devenyi Rg, lam Wc. Incidence of endophthalmitis and use of antibiotic prophylaxis after intravitreal injections. Ophthalmol [internet]. 2012 aug:119(8):1609-14.
  • Milder E, Vander J, Shah C, Garg S. Changes in antibiotic resistance patterns of conjunctival flora due to repeated use of topical antibiotics after intravitreal injections.
  • Ophthalmol [internet]. 2012 jul:119(7):1420-4.
    Kim sj, toma ks. Ophthalmic antibiotics and antimicrobial resistance. A randomized, controlled study of patients undergoing intravitreal injections. Ophthalmol [Internet]. 2011 jul(7);118:1358–1363.

    How this list was made How this list was made

    RANZCO has undertaken a multi-stage consultation process to ensure that the entire spectrum of medical eye specialists in Australia and New Zealand can contribute to the process of identifying and refining the top five recommendations. The first stage included a survey of fellows to identify possible recommendations, which were then narrowed down and by a dedicated “Choosing Wisely” committee of RANZCO members. A second survey was then sent to all members to provide feedback on the list of five and received a high response rate. Based on the extensive feedback received via the survey, RANZCO’s “Choosing Wisely” committee crafted the final wording of the top five recommendations. Finally, the RANZCO board discussed and approved the recommendations.

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