From the American Academy of Ophthalmology

This trial included 48 patients receiving 0.05 mL ranibizumab injections who were randomized to two anesthetic methods. In one method, cotton swabs were soaked in 4% lidocaine applied to the globe with moderate pressure; in the other, 3.5% lidocaine gel was applied without pressure. Decompressing the eye with cotton swabs during prep produced a significantly lower IOP post injection, with fewer patients experiencing IOP ≥50 mm Hg immediately after injection (10% vs. 35%; P<0.001). Journal of Glaucoma, October/November 2014