Why do we still give prophylactic topical antibiotics after intravitreal injections?

Intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections are among the most frequently performed procedures in modern medicine, with millions administered annually worldwide. Although post-injection infectious endophthalmitis is a devastating complication, its incidence remains exceptionally low (approximately 0.02–0.05%). Nevertheless, topical antibiotics continue to be prescribed routinely by many clinicians despite an overwhelming body of evidence demonstrating no protective benefit. This disconnect raises an important question: why do we continue prescribing a treatment that appears ineffective, costly, and potentially harmful?