Date of Award

January 2012

Document Type


Degree Name

Medical Doctor (MD)



First Advisor

Ron A. Adelman

Subject Area(s)

Ophthalmology, Music


This randomized clinical trial investigates the effects of music therapy on anxiety, perceived pain and satisfaction in patients undergoing intravitreal injections in the outpatient setting. The a priori hypothesis is that music therapy would reduce anxiety. 73 patients were recruited from the retina clinic at one institution and randomized into a music therapy (n = 37) or control (n = 36) group. Prior to injection, patients completed the state portion of the State Trait Anxiety Inventory (STAI-S). The music therapy group listened to classical music through computer speakers while waiting for and during the injection. The control group underwent the injection in the same setting without music. Afterwards, all patients completed another STAI-S and a satisfaction and pain questionnaire. The main outcome measures were objective anxiety derived from STAI-S scores and subjective pain and anxiety from the post-procedure questionnaire. Data analysis showed that the music therapy group had a greater decrease in anxiety than the control group (p = 0.0480). Overall, 73% of all patients requested music for future injections (p = 0.0001). The music therapy group (84%) requested music in future injections more frequently than the control group (61%) (p = 0.0377). Both groups reported similar levels of pain (p = 0.5879). In conclusion, classical music before and during intravitreal injections decreases anxiety in patients without decreasing pain. Most patients desire to have music during future injections. Music therapy is a low-cost, easy, safe intervention that reduces anxiety during intravitreal injections in the outpatient setting.


This thesis is restricted to Yale network users only. This thesis is permanently embargoed from public release.