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5 Ophthalmologist Tips for People with Diabetic Macular Edema

Over time, when diabetes isn’t well-managed, blood sugar can be too high for too long. Along with many other complications, the high blood sugar can cause damage to blood vessels in the retina of the eye. The retina, a specialized nerve layer that lines the inner eye wall, is responsible for sensing light and sending images to your brain; basically, it allows you to see. When blood vessels in the retina are damaged, the vessels can become leaky. Sometimes, the leaky blood vessels cause swelling on the retina, and we call that diabetic macular edema (DME). This is one of the main reasons diabetics can lose vision, which is why it’s crucial patients are educated and know the steps to take care of their eyes.

Sometimes, a new patient comes in with diabetic macular edema and I know if I’d looked at their retina five years earlier, I would’ve seen the signs and we could have prevented it from progressing. Whenever you experience changes to your vision, like if things seem distorted or wavy, if items are blurry, or if you see little spots floating around, don’t wait to see an ophthalmologist. People with diabetes are at an especially high risk of developing vision problems, so they should make sure to get a dilated eye exam every single year. If we find problems early, we can prevent vision loss and keep the disease from getting worse.

In recent years, an exciting new treatment has come to the market for diabetic macular edema, as well as other conditions like macular degeneration. This new medication, called anti-VEGF therapy, comes in the form of an injection and is the first-line treatment for diabetic macular edema.

That can be scary for a lot of my patients, who don’t love the idea of receiving an injection in their eye. This concern is understandable, but I try to emphasize the success of the treatment makes a moment of discomfort well worth it. These injections, which block something called the vascular endothelial growth factor (VEGF), are safe, with rare side effects and proven results.

Most patients require a series of injections every month or two initially to improve their vision. The doctor will numb your eye and give you the shot, with the whole procedure taking about five minutes. The shot itself lasts about a second. Most patients barely feel anything and the shot is over before they know it. I advise patients to not rub their eyes and to lubricate their eye with artificial tears for a few hours afterwards. They typically see results in the next week or so.

When your blood sugar levels are stable, your overall health is better, and that includes your eyes. I know there’s a lot to manage with diabetes, from making healthy diet choices to taking medication to exercising more often. With these lifestyle changes coming all at once, it can be difficult to keep up with your doctor’s appointments. However, it’s crucial to follow-up with your endocrinologist regularly, and also see your ophthalmologist for annual dilated eye exams. When your diabetes is controlled, your diabetic eye disease can be better controlled, as well.

I’m able to restore vision for many of my diabetic macular edema patients, but for some, the damage is too far gone and we can’t get vision completely back. When that’s the case, and they’re dealing with limited vision, I recommend they see a low vision rehab specialist. These specialists are trained to help people navigate life with vision loss, from figuring out the best reading aid to helping you manage day-to-day activities with the vision you have. If you’re living with low vision, you don’t need to reinvent the wheel; there are many people out there who are specifically trained to help you.

When it comes to vision loss, it can be really hard to stay optimistic about the future. Some patients surprise me with their positivity, but many patients have a hard time dealing with their new reality when vision isn’t as good as it once was. I encourage my patients to keep their spirits up as much as they can, especially considering we have new, effective treatments that weren’t even available 15 years ago. The field has rapidly progressed and is showing no signs of slowing down, so I’m excited to see how much better it will be even five years from now.