Should non-physicians be allowed to perform intravitreal injections?

Although most intravitreal injections in the United States are performed by retina specialists, an increased treatment burden has forced some states to consider allowing alternative providers to perform these injections, according to a study presented at the 2020 Virtual ASRS Meeting which examined the credentials of providers who performed intravitreal injections.

Researches collected data on the number of intravitreal injection services and the provider’s medical specialty and degree from Medicare data for the year 2017 and then determine board certification status for each provider.

There were 3,102,033 intravitreal injections performed in 2017, according to the CMS data. Overall, 96% of injections were administered by board certified ophthalmologists, with 92% administered by retina specialists. Only 0.13% of injections were performed by non- ophthalmologists. Only 2 nurse practitioners and 3 physician assistants (0.016%) administered injections.

The authors concluded that intravitreal injection by an ophthalmologist, specifically a retina specialist, remains the standard of care in the United States.

More data is needed on safety and outcomes when intravitreal injection is done by non-physicians.

Reference
Emerson GG, et al. Medicare 2012-2017 intravitreal injections: Certification and credentials of providers. Presented at: 2020 ASRS Virtual Meeting.