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What is diabetic macular oedema?

Diabetic eye disease is a leading cause of blindness registration among working age adults in India. It is caused by changes to the tiny blood vessels of the retina (the light sensitive layer at the back of the eye). In diabetic macular oedema, blood vessels leak fluid into the retina.

How does diabetic macular oedema cause vision loss?

Vision loss occurs when the fluid reaches the macula (the centre of the retina that provides sharp vision) and builds up, causing swelling. At first, you may not notice changes to your vision. Over time, diabetic macular oedema can cause your central vision to become blurred. A healthy macula is essential for good vision.

Who is at risk of diabetic macular oedema?All people with type 1 and type 2 diabetes are at risk of diabetic macular oedema. You are at greater risk if you:

  • Have had diabetes for a long time–about one in three people living with diabetes for 20 years or more will develop diabetic macular oedema
  • Have poorly controlled blood sugars
  • Havehigh blood pressure
  • Have high cholesterol levels
  • Smoking
  • Pregnancy
  • Large studies have shown that people who have well-controlled blood sugar, blood pressure and cholesterol levels, and do not smoke are less likely to develop diabetic macular oedema.

    How to reduce the risks of diabetic macula oedema?

    To reduce the risk of diabetic macular oedema, it is important not to smoke and to ensure that your blood sugar, blood pressure, and cholesterol levels are well controlled.

    How is diabetic macular oedema detected?

    Diabetic macula oedema may be detected during your annual eye screening visits, which are offered to all patients with diabetes. Digital photographs of your retina may show signs of early diabetic macular oedema. You may not notice any changes in your vision at this stage. If diabetic macular oedema is detected, you will be referred to the retina clinic.

    What happens when I attend the medical retina clinic? You will have a comprehensive eye examination that includes:

    • Visual acuity test: A sight test that measures how well you see at different distances
    • Eye pressure test: A test that measures the pressure of your eyes –numbing drops may be used as part of this test
    • Dilated eye examination: Drops are placed in your eyes to dilate (widen) your pupils so that the back of your eyes can be examined You may also undergo tests such as a:
      • Fluorescein angiography, a diagnostic test which involves the injection of fluorescein (yellow) dye into your bloodstream via a vein in your hand or arm, followed by a series of retinal photographs taken over several minutes. The test gives your doctor more information about the condition of your retina and this helps decide which treatment is most appropriate.
      • Optical coherence tomography (OCT) measures the amount of retinal swelling (macular oedema) which, like fluorescein angiography, helps decide which treatment is most appropriate. OCT is also used to monitor your retina over time and to show how effective treatment may have been. It is effectively ‘optical ultrasound’, a non-invasive test, using reflections from within your retina to provide a cross-sectional picture of the retina.

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