AOA 2026: Helping patients brave the eye of the needle

Mohammad Rafieetary, OD, FAAO, FORS, DipABO, ABCMO, provided a brief but content-rich overview on his AOA 2026 presentation titled “Eye of the Needle Returns: Navigating the Patient’s Journey Receiving Intravitreal Injections.” The optometrist from the Charles Retina Institute in Germantown, Tennessee, summarized the key themes concerning the patient experience in retina clinics, particularly for those receiving intravitreal injections.

Rafieetary explained that his lecture centers on what patients go through when they are referred from community eye care providers to high-volume retina clinics, such as the Charles Retina Institute, where up to 100 patients per day may receive injections. The presentation included interviews with patients and colleagues, as well as interactive discussion with attendees, emphasizing the often-overlooked emotional and informational journey of patients entering what he terms a “needle black hole”—a cycle of ongoing, repeated injections for chronic retinal diseases.

He stressed that many referring eye care providers do not adequately prepare patients for the fact that they will be receiving an injection at the retina clinic. As a result, patients may arrive frightened, surprised, and anxious about pain. Rafieetary highlighted the importance of clear communication and expectation-setting: explaining that conditions such as age-related macular degeneration, diabetic retinopathy, diabetic macular edema, and retinal vein occlusions are chronic, often requiring long-term and recurrent treatment.

He also underscored the crucial role of continued involvement by the referring doctors. These providers should not simply hand off the patient; rather, they should maintain periodic follow-up to encourage adherence to treatment and to manage non-retinal issues, particularly anterior segment problems (eg, dry eye). Using a vivid analogy, he notes that visiting a retina specialist for anterior segment complaints is like asking a neurologist about dandruff—illustrating that retina clinics are highly specialized, high-throughput environments where time and focus must be devoted to the primary retinal pathology.

Rafieetary closed by situating his comments in the reality of clinical workload—mentioning 56 patients on his schedule that day—to reinforce why retina clinics cannot address every ocular issue, and why collaborative care and communication with community providers are indispensable to optimal patient outcomes.