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It is known to cause various complications in your body parts and even be the reason for premature death.

Of the many complications that arise due to diabetes, one of the most prevalent issues is the deterioration of eyesight.

So, in this article, let’s look at everything you need to know about DME, which is related to diabetes and eyesight.

What is Diabetic Macular Edema (DME)?

Diabetic macular edema (DME) is a complication of diabetes or diabetic retinopathy. People with type 1 or type 2 diabetes are more prone to DME. 

How?

High blood glucose weakens the blood vessels in your eyes and leads to diabetic retinopathy and also Diabetic macular edema.  

Too much blood sugar can damage or block the small blood vessels in the retina of the people with diabetes, resulting in diabetic retinopathy. DME is a dangerous eye condition caused by a breakdown of the blood-retinal barrier as a result of long term high blood sugar levels, resulting in retinal thickness around the fovea, the macula’s centre. 

The macula is the central portion in the retina, blood vessel filled lining in the back of the eye. The macula allows us to focus and see minute details clearly. DME usually progresses over time and happens when excess fluid builds up in the macula of the eye. This fluid makes the macula swell (edema), causing blurred sight and other visual issues.

There are possibilities for serious eye complications with diabetic macular edema such as blindness and also other vision problems.

Types of Diabetic Macular Edema(DME):

  • Focal DME: Tiny spots of fluid leaking in the macula
  • Diffuse DME:  This condition has leaks and swelling all over the macula.

Note: Eyesight is worse with diffuse DME.

The treatments for focal and diffuse DME are different, yet they both entail laser procedures. The majority of doctors treat focal DME with focal laser treatment and diffuse DME with grid laser treatment. However, both techniques are designed to stop macula leaking.


Causes & Risk Factors Of Diabetic Macular Edema

DME is an eye disorder that affects persons who have diabetes, including type 1 and type 2. High blood sugar levels that persist for a long time due to poor glucose control can harm small blood vessels in the body, including the eye. DME can also occur at any stage of diabetic retinopathy.

Following are a few risk factors for DME: 

  1. Type-1 or Type-2 Diabetes
  2. Older age
  3. Eye surgery
  4. Inflammatory eye diseases
  5. Increased blood pressure 
  6. High cholesterol levels
  7. Pregnancy
  8. Kidney disease
  9. Sleep apnea
  10. Smoking 
  11. Sedentary lifestyle &
  12. Diabetic retinopathy

Signs and symptoms Of DME

It’s possible that you have DME and aren’t aware of it because it doesn’t hurt and your eyesight changes so slowly that you don’t notice.

Symptoms include: 

  • Wavy or blurry vision
  • Colors look faded or washed out
  • Sudden increase in eye floaters
  • Double vision

When to see the Doctor?

There may be no symptoms in the early stages of DME. If you have diabetes, you should see an eye doctor once a year to have your eyes examined for any changes. Early detection and treatment of retinopathy or DME can prevent or restore vision loss.

Contact your eye doctor if you notice any of the following symptoms: 

  1. Blurry vision
  2. Seeing colors that look washed out
  3. Seeing more floaters in your vision
  4. Double vision

Diagnosis of DME

Before the testing, your doctor may ask many questions to understand:

  • Changes and types of changes in your vision
  • Your history of diabetes
  • Your family medical history
  • Recent blood sugar levels
  • Blood pressure and cholesterol levels
  • Other medical conditions.

The eye tests usually include,

  1. Visual Acuity Test: To determine how well you can see from a distance.
  2. Dilated eye exam: The doctor will use drops to dilate or widen your pupils to get a closer look at the damaged blood vessels and retina.
  3. Fundus imaging: Images of the retina are captured to find irregular blood vessels.
  4. Optical Coherence Tomography (OCT): This employs special cameras to capture the minute damage of the retina and to measure the swelling.
  5. Fluorescein angiography: This uses a dye to understand the location and amount of leakage in your eye. The dye is injected into your arm, which then travels to your eye.

Your doctor will perform the appropriate testing based on your condition.

Treatment for Diabetic Macular Edema

If you are diagnosed with DME(Diabetic Macular Edema), treatments can help you protect your eyesight and may reverse vision loss. There are several effective treatment options available and it’s easiest to treat when diagnosed early and monitored regularly by an eye care doctor.

  1. Laser therapy
  2. Intravitreal anti-VEGF drug injections
  3. Intravitreal corticosteroid injections
  4. Focal laser photocoagulation and 
  5. Vitrectomy

Note: Laser therapy can help you protect your current vision while also preventing further vision loss.

Laser therapy

This treatment is usually done in a clinical setting under the supervision of your doctor.

It employs the use of tiny lasers to seal the leakage in your eyes. Doing this will prevent further vision loss and damage.

Depending on your severity, you may need several laser treatments to control and repair the eye damage, and may also require additional treatments.

Medications

As mentioned earlier, the type of treatment will be determined based on your eye damage and its severity.

In the case of medications, the medicine will be injected into your eye with the help of a tiny needle.

The doctor will first numb your eye before injecting the medicine to prevent pain.

These medications will prevent any abnormal blood vessel growth to reduce swelling and prevent further damage to the eye.

Recovery

The usual recovery time after the treatment is 3-6 months. This time is needed for the eye to heal and the swelling around the retina and macula to subside.

Some of the common side effects are light sensitivity, black spots in the middle of the vision, and eye irritation.

However, these side effects are normal and will subside as your eye heals.

Prevention Tips Of DME

Tips to avoid DME(Diabetic Macular Edema):

  1. Maintain good blood glucose, cholesterol and blood pressure
  2. Get a comprehensive dilated eye exam at least once or twice a year
  3. Comprehensive dilated eye exam is necessary for diabetics
  4. Pregnant women with diabetes should have a comprehensive dilated eye exam as frequently as possible as they may need additional exams
  5. Pregnant women with diabetes should get comprehensive dilated eye exams more often than usual, as additional exams may be required
  6. Maintain a healthy lifestyle that is exercise regularly, and have a healthy diet 

To avoid this, we recommend Annual Eye Check-ups for early detection of such disorders.

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