Diabetic macular edema (DME) develops from an eye condition called diabetic retinopathy (DR) and is a leading cause of vision loss in people with diabetes. DME is associated with swelling or thickening of the retina at the back of the eye, and leaking of blood and fluid into the macula. The macula is an area of the retina that is particularly sensitive to light and is what you use for central vision, allowing you to see sharp, fine detail.
There are several important things you can do to help reduce your risk of DME. These include addressing the underlying factors that contribute to DME, including monitoring and controlling your blood glucose level, your blood pressure, and your cholesterol and lipids. This can be achieved by following your doctor’s instructions and taking any medications he or she recommends, as prescribed, and paying close attention to leading a healthy lifestyle by eating well, exercising, stopping smoking and limiting alcohol intake.
If DME has advanced to the point where you have symptoms, you may experience blurred vision, blind spots, distorted lines and/or faded colours in your vision. If you are experiencing any of these symptoms, it is very important to see an eye specialist in order to have the best chance preserve your vision.
An ophthalmologist is a medical doctor who commonly acts as both physician and surgeon. He or she examines, diagnoses and treats diseases and injuries in and around the eye. People with DME are managed by ophthalmologists who specialize in eye conditions that affect the back of the eye.
There are typically a number of possible referral routes into an ophthalmologist who can diagnose and manage your DME, including an optometrist, an endocrinologist / diabetologist, non-treating ophthalmologist and a primary care physician. It is common for many patients to be referred to a treating ophthalmologist specializing in DME via their primary care physicians.
Currently, there is no cure for DME. However there are a number of effective treatments available. Options include laser treatment to swollen areas in the macula or injections into the eye to try to stop the leaking and reduce swelling. Injections can be anti-VEGF therapy or a steroid.
Anti-VEGF and steroid therapies are both given as an injection into the eye.
For anti-VEGF therapy, you will be asked to lie down, and your eye will be gently held open for you; your face and the area around your eye may be covered with a sterile drape. The doctor or nurse will use some anesthetic on your eye to make it numb. You will then be asked to look to one side, and they will give you the injection. It will only take a few seconds.
Steroids are injected in a similar manner as anti-VEGF therapy. You will be asked to lay down and your eye will be gently held open for you. Your face and the area around your eye will be covered with a sterile drape. The doctor or nurse maybe use antibiotic drops and give you a local anesthetic to reduce any pain. They will then give you the injection. After the injection is completed, they will then confirm that the implant is in place and monitor you for up to 30 minutes.
You may feel a little pressure in your eye when you receive the injection, and occasionally there may be some discomfort during and afterwards. For a few days after the injection, you may experience red eye, a sore and gritty eye, or blobs and small specks in your vision, and transient flashing lights or swirls of light immediately after the injection. These should go away after a few days, but if they don’t, or if you experience any other problems, speak to your doctor or nurse straight away. You will be given more information about your treatment and any side-effects at your appointment.
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