Intravitreal, Intracameral, Intrastromal & Subconjunctival Drug Doses
Last updated: October 2026
Safety first: doses below are standard published starting points for adults. Always check units (mg vs µg) twice, confirm against your hospital protocol or pharmacist, and use preservative-free preparations for anything injected into the eye.
Intravitreal antibiotics (endophthalmitis)
| Drug | Dose | Notes |
|---|---|---|
| Vancomycin | 1 mg / 0.1 mL | Gram-positive cover. For treatment of endophthalmitis, not prophylaxis (see the HORV warning below). |
| Ceftazidime | 2.25 mg / 0.1 mL | Gram-negative cover. Inject with a separate syringe and needle from vancomycin (they precipitate when mixed). |
| Amikacin | 0.4 mg (400 µg) / 0.1 mL | Alternative Gram-negative cover, for example with beta-lactam allergy. Risk of macular infarction. |
| Gentamicin | 0.2 mg (200 µg) / 0.1 mL | Largely abandoned because of macular infarction. Prefer ceftazidime or amikacin. |
Intravitreal antifungals
| Drug | Dose | Notes |
|---|---|---|
| Voriconazole | 50–100 µg / 0.1 mL (100 µg commonly used) | Broad spectrum, including Aspergillus and Fusarium |
| Amphotericin B | 5–10 µg / 0.1 mL | Retinal toxicity at higher doses |
Intravitreal antivirals (CMV retinitis, acute retinal necrosis)
| Drug | Dose | Notes |
|---|---|---|
| Ganciclovir | 2 mg / 0.1 mL (standard). Low-dose regimens of 200–400 µg have also been reported. | Note the units: milligrams for the standard dose, micrograms for low-dose regimens |
| Foscarnet | 2.4 mg / 0.1 mL (1.2 mg / 0.05 mL) | Often repeated once or twice weekly alongside systemic antivirals |
| Cidofovir | 20 µg / 0.1 mL | Rarely used now because of hypotony and uveitis |
Intravitreal steroids
| Drug | Dose |
|---|---|
| Dexamethasone (solution) | 400 µg / 0.1 mL |
| Triamcinolone acetonide (preservative-free) | 1–4 mg / 0.1 mL (4 mg most common) |
| Dexamethasone implant (Ozurdex) | 0.7 mg biodegradable implant. See intravitreal implants. |
Anti-VEGF agents
| Drug | Dose | Notes |
|---|---|---|
| Bevacizumab (Avastin) | 1.25 mg / 0.05 mL | Off-label, repackaged from 100 mg/4 mL or 400 mg/16 mL vials (25 mg/mL). Aseptic aliquoting is essential. |
| Ranibizumab (Lucentis and biosimilars) | 0.5 mg / 0.05 mL (0.3 mg in some DME labels; 0.2 mg in ROP) | Several biosimilars are available, including in India |
| Aflibercept (Eylea) | 2 mg / 0.05 mL | Standard dose |
| Aflibercept 8 mg (Eylea HD) | 8 mg / 0.07 mL | High-dose formulation allowing longer intervals |
| Faricimab (Vabysmo) | 6 mg / 0.05 mL | Bispecific: VEGF-A and angiopoietin-2 |
| Brolucizumab (Beovu) | 6 mg / 0.05 mL | Risk of retinal vasculitis and vascular occlusion, so use is now limited |
| Pegaptanib (Macugen) | 0.3 mg / 0.09 mL | Historical only: discontinued |
Related: the current anti-VEGF landscape and treat-and-extend regimens.
LVPEI dosage chart
Below is a dosage chart prepared by LVPEI, also available as a PDF.
Download the LVPEI dosages chart (PDF)
Intrastromal (corneal) injections
| Drug | Dose |
|---|---|
| Voriconazole | 50 µg / 0.1 mL, given in divided injections around the infiltrate |
| Amphotericin B | 5–7.5 µg / 0.1 mL |
Mitomycin C is not injected: it is applied topically, typically 0.02% for about 15–30 seconds after surface ablation to reduce haze, or with a sponge in glaucoma and pterygium surgery.
Intracameral drugs (end of cataract surgery)
| Drug | Dose | Notes |
|---|---|---|
| Cefuroxime | 1 mg / 0.1 mL | The ESCRS endophthalmitis study regimen |
| Moxifloxacin | Commonly 100–500 µg in 0.1 mL; 0.1 mL of undiluted preservative-free 0.5% gives 500 µg | Regimens and dilutions vary, so follow one protocol consistently |
| Cefazolin | 1 mg / 0.1 mL | |
| Amphotericin B | 5–10 µg / 0.1 mL | For fungal infection, not routine use |
| Adrenaline (epinephrine) | 1:10,000 (0.1 mL of 1:1000 diluted with 0.9 mL) | Preservative-free and bisulfite-free only. For pupil dilation and floppy iris. |
| Acetylcholine 1% or carbachol 0.01% | As per the product | Intracameral miotics |
Do not use vancomycin for prophylaxis inside the eye. Intracameral vancomycin and vancomycin in the irrigating fluid have been linked to haemorrhagic occlusive retinal vasculitis (HORV), a rare but blinding reaction, sometimes in both eyes. The FDA and ASCRS/ASRS advise against prophylactic intraocular vancomycin. Gentamicin in the irrigating fluid has also been abandoned because of retinal toxicity.
Subconjunctival injections
| Drug | Dose |
|---|---|
| Vancomycin | 25 mg / 0.5 mL |
| Ceftazidime | 100 mg / 0.5 mL |
| Amikacin | 25 mg / 0.5 mL |
| Dexamethasone | 6 mg / 0.25 mL |
See also types of ocular injections, endophthalmitis management and microbial keratitis work-up.
Key sources
- AAO: FDA warns of HORV risk with prophylactic intraocular vancomycin
- Eylea HD (aflibercept 8 mg) dosing
- Vabysmo (faricimab) prescribing information
- ESCRS Endophthalmitis Study Group. J Cataract Refract Surg 2007;33:978–88
- LVPEI dosage chart (above)
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