Triamcinalone (subtenon kenalog and intravitreal Triesence) is a sustained release steroid used to delivery high dose steroids directly to the eye


Triamcinolone is a synthetic corticosteroid that is commonly used to treat inflammation.

When administered as an injection, triamcinolone has a long-acting effect in controlling local inflammation. This method of delivery allows the medication to be directly introduced into specific areas of the body where inflammation is a concern. Injections of triamcinolone are used all over the body: in joints, soft tissues, and other localized sites.  They reduce inflammation and pain associated with conditions such as arthritis, bursitis, tendonitis, and certain skin disorders.

As a long-acting steroid, triamcinolone provides sustained relief of inflammation in the eye over an extended period. It’s duration of action is variable.  Around the eye, it can suppress inflammation for at least a month and sometimes as long as a year.

The main risk of steroids around the eye is the risk of elevated intraocular pressure which can cause damage to the optic nerve.  This is called steroid responsive glaucoma.  Anyone treated with triamcinolone around the eye needs to have their intraocular pressure monitored.

Two formulations of triamcinolone are used around the eye:

  • Kenalog is given as a subtenon injection (next to the eye)
  • Triescence is given as an intravitreal injection (into the eye).


A subtenon injection of Kenalog (triamcinolone acetonide) is often used to treat intraocular inflammation or uveitis. It can be particularly helpful at treating macular edema associated with uveitis or intraocular (cataract) surgery.  Uveitis is an inflammatory condition affecting the inside of the eye.  It can be treated with topical therapy.  If topical therapy is not strong enough to control the inflammation, one reasonable treatment option is a subtenon kenalog injection.

The subtenon injection involves the administration of triamcinolone acetonide into the space between the outer surface of the eye (sclera) and the conjunctiva (the thin, transparent membrane covering the sclera). This allows the steroid medication to be delivered in close proximity to the inflamed structures within the eye.  It is not an intraocular infection, so the risk of infection from the treatment if very low.

The anti-inflammatory properties of triamcinolone acetonide can be particularly beneficial in managing the symptoms of uveitis, including pain, redness, light sensitivity, and vision disturbances.

Some key points regarding the use of subtenon Kenalog injections for eye inflammation:

  1. Localized Treatment: The injection targets the affected area directly, providing a localized treatment approach while minimizing systemic exposure compared to oral or systemic steroid medications.
  2. Longer Duration of Action: Triamcinolone is a long-acting steroid, which means that a single subtenon injection can offer sustained anti-inflammatory effects over an extended period, reducing the need for frequent treatments.
  3. Potential Side Effects: While subtenon injections can be effective in managing inflammation, they may be associated with side effects such as increased intraocular pressure, cataract formation, or infection. Regular follow-up with the treating physician is essential to monitor for any adverse effects.
  4. Individualized Treatment: The decision to use subtenon Kenalog injections will depend on the specific characteristics of the eye condition, the severity of inflammation, and the patient’s overall health. This treatment is usually avoided in people with glaucoma.

Triesence is a brand name for a formulation of triamcinolone acetonide used for intravitreal injections. Intravitreal injections of Triesence are administered directly into the vitreous cavity of the eye for the treatment of various eye conditions associated with inflammation.

  1. Intravitreal Administration: Triesence is specifically formulated for intravitreal use, meaning it is injected into the vitreous humor of the eye. This allows for a targeted and localized delivery of the corticosteroid to address inflammation within the eye.
  2. Indications: Triesence is often used in the management of conditions such as diabetic macular edema, macular edema due to retinal vein occlusion, and certain types of uveitis. These conditions involve inflammation and swelling in the eye, particularly in the macula, which can impact vision.
  3. Anti-Inflammatory Effects: Like other forms of triamcinolone acetonide, Triesence has potent anti-inflammatory properties. It works by suppressing the immune response and reducing inflammation within the eye.
  4. Duration of Action: The duration of action of Triesence is generally longer compared to some other corticosteroids. This means that a single injection may provide sustained anti-inflammatory effects over a period of time, reducing the need for frequent injections.
  5. Monitoring and Potential Side Effects: Regular monitoring by an ophthalmologist is important for individuals receiving Triesence injections. Potential side effects can include an increase in intraocular pressure, cataract formation, and the risk of infection. The ophthalmologist will assess and manage any adverse effects that may arise.