Anti-VEGF injections are the sight-preserving standard of care for wet (neovascular) AMD. A consultant medical-retina specialist injects a tiny dose of an anti-VEGF drug into the eye to dry up the abnormal blood vessels leaking under the macula. With same-day diagnosis-to-injection, OCT-guided treat-and-extend dosing and a choice of the newest long-acting drugs, the goal is to stabilise — and often improve — your central vision.
What anti-VEGF injections treat
In wet age-related macular degeneration, abnormal new blood vessels grow under the macula and leak fluid and blood, distorting and rapidly destroying central vision. Anti-VEGF (anti-vascular endothelial growth factor) drugs switch off the signal that drives those vessels, drying the macula and protecting the central vision you rely on for reading, faces and driving.
Treatment is started for active intraretinal, subretinal or sub-RPE fluid on OCT, and also treats related conditions such as polypoidal choroidal vasculopathy, retinal angiomatous proliferation and myopic choroidal neovascularisation. New central distortion in anyone over 50 is a medical-retina emergency — the sooner treatment starts, the better the visual outcome.
Treatment options
All anti-VEGF agents dry the macula; they differ in how long they last and their evidence base. Your consultant matches the drug to your lesion type, treatment goals and how often you can attend.
How the injection works
The injection is a day-case procedure in a sterile clean-room suite. The eye is anaesthetised with topical proxymetacaine drops and a small sub-conjunctival lidocaine pledget, then cleaned with povidone-iodine and held open with a lid speculum. The chosen drug is injected through the pars plana — the safe zone 3.5–4.0 mm behind the edge of the cornea — into the vitreous cavity using a fine 30 to 32-gauge needle. The whole injection takes about two seconds.
For new symptoms our same-day pathway arranges OCT, OCT angiography and consultant medical-retina assessment, with the first loading injection given the same day where indicated — the speed that most protects vision in new wet AMD.
New wavy lines or a blur in your central vision? This is a medical-retina emergency — be seen the same day.
Book your assessmentAfter your injection & treat-and-extend
Day 0 — Straight after
You can resume normal activity the same day. The eye feels gritty for 12–24 hours from the iodine prep, and small floaters or a red patch on the white of the eye are common and settle on their own.
Weeks 0–8 — Loading phase
Three monthly injections at weeks 0, 4 and 8 to dry the macula and establish control of the new vessels.
From week 12 — Treat-and-extend
Each visit combines OCT, the next injection and a planned interval — extended by 2-week steps when the macula is dry, shortened when fluid recurs. Most patients settle at 8–16 weeks; Eylea HD and Vabysmo can reach 20.
Ongoing — Lifelong monitoring
OCT, intermittent OCT angiography and a home Amsler grid. You are reviewed within 7–14 days of any new distortion, new floaters, pain, redness or drop in vision.
Cost of private wet AMD injections
London 2026 self-pay pricing is £900–1,800 per injection per eye, depending on the drug, with a three-month loading course at £2,700–5,400 and annual maintenance of £4,000–10,000. Fees are all-inclusive of the same-day consultant assessment, OCT and OCT angiography, the drug, the sterile clean-room injection and structured follow-up. Eylea HD 8 mg and Vabysmo sit at the top of the range; off-label Avastin is the cheapest. See the Eylea HD price guide or compare Vabysmo pricing.
Frequently asked questions
How much does a private anti-VEGF injection for wet AMD cost in London in 2026?
A single private anti-VEGF intravitreal injection for wet AMD typically costs £900–1,800 per eye in London in 2026, depending on the drug. Eylea HD 8 mg aflibercept and Vabysmo (faricimab 6 mg) sit at the top of the range; Eylea 2 mg, Lucentis (ranibizumab 0.5 mg) and ranibizumab biosimilars sit in the middle; off-label Avastin (bevacizumab 1.25 mg) is the cheapest. The all-inclusive fee covers the consultant medical retina specialist, the drug, the sterile injection pack, OCT and structured 4-week follow-up.
How many anti-VEGF injections will I need for wet AMD?
Almost all wet AMD patients start with three monthly loading injections at weeks 0, 4 and 8. Maintenance is then individualised on a treat-and-extend protocol: the consultant extends the interval by 2-week steps when the macula is dry on OCT and shortens it by 2-week steps when fluid recurs. Most patients reach a maintenance interval of 8 to 16 weeks; Eylea HD 8 mg and Vabysmo can extend many patients to 12, 16 or 20 weeks within 12 to 24 months.
Will my wet AMD vision improve with anti-VEGF injections?
Pivotal trials (CATT, IVAN, VIEW 1 and 2, HARBOR, TENAYA, LUCERNE, PULSAR) and UK real-world data show that around 30 to 40 percent of patients gain three or more lines of vision at 12 months, around 90 percent stabilise (lose fewer than 15 letters) and around 5 to 10 percent continue to lose vision despite optimal treatment. Earlier diagnosis and a complete loading-plus-treat-and-extend protocol are the strongest predictors of a good outcome.
Are anti-VEGF injections painful?
No. The eye is anaesthetised with topical proxymetacaine drops and a sub-conjunctival lidocaine pledget. The 30 to 32-gauge injection takes around two seconds and most patients feel pressure rather than pain. There is mild gritty discomfort for 12 to 24 hours from the iodine prep, and small floaters or subconjunctival haemorrhages are common and self-limiting.
What are the risks of intravitreal anti-VEGF injections?
Endophthalmitis (a sight-threatening intra-ocular infection) occurs in around 1 in 2,000 to 1 in 5,000 injections, and sterile intra-ocular inflammation in around 1 in 200 to 1 in 1,000 (higher with brolucizumab). Retinal detachment, cataract progression, a transient pressure spike, subconjunctival haemorrhage and floaters are also recognised. The small systemic risk is outweighed by the visual benefit in wet AMD on current UK consensus.
What is the difference between dry and wet AMD?
Dry (non-neovascular) AMD is the slow drusen-and-atrophy form affecting around 90 percent of AMD patients, managed with AREDS2 vitamins and lifestyle measures. Wet (neovascular) AMD is the abrupt new-vessel-and-fluid form that affects around 10 percent and causes the majority of severe AMD vision loss; it is treated with intravitreal anti-VEGF injections.