title: Patients' tolerance of bimanual lid retraction versus a metal speculum for intravitreal injections.
abstract: OBJECTIVE
  To compare patients' acceptance of and correlate their pain level for bimanual versus metal speculum fixation in intravitreal injections.
  
  
  METHODS
  Prospective analysis.
  
  
  METHODS
  Seventy-three eyes of 56 patients.
  
  
  METHODS
  A questionnaire indicating patients' discomfort and pain grading immediately after intravitreal injections using either bimanual fixation or metal speculum fixation (Barraquer Wire Speculum).
  
  
  RESULTS
  Fifty-six patients who underwent intravitreal injections were enrolled in this study for various conditions. Patients' overall pain and discomfort were as follows, right eye - bimanual was 0.3 on our grading scale with a standard deviation of 0.54, right eye - metal was 1.6 on our grading scale with a standard deviation of 1.5, left eye - bimanual was 0.41 on our grading scale with a standard deviation of 0.87, and left eye - metal was 1.91 on our grading scale with a standard deviation of 1.14 (P=0.003).
  
  
  CONCLUSIONS
  Patients who underwent bimanual fixation had a much more comfortable experience with less pain in comparison to patients who underwent metal speculum fixation.
authors.affiliation: Department of Ophthalmology, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors.forename: Khadijah
authors.initials: K
authors.lastname: Alattas
keywords: AMD; Avastin; diabetic retionpathy; eye injection