What are some methods to deal with IOP elevations with intravitreal injections in a patient without glaucomatous damage that does not want to have AC taps with each injection?

In this situation, depending on the elevated IOP, use the standard medical approach: Iopidine1%, Cosopt, Alphagan 0.2%, and in some cases, Diamox 250 mg. Wait for half an hour and repeat if necessary, or send the patient home with one or more drugs. Of course, make sure of drug selective contraindic...

I have to admit this is not something I encounter very often in my practice. In the rare situations where I have seen significant IOP elevations with intravitreal injections in patients without underlying glaucomatous damage, I typically don't need to perform routine anterior chamber taps.

I did ask...

Although not common, IOP can spike dramatically (over 50) with injections. In these situations, drops don’t work well. Patient that has an IOP spike usually spikes every time.

Has anyone tried ocular massage in these situations? I have tried it once, and it worked.