If you have diabetes, you know how much you have to manage it. There are many things to do, such as controlling your blood sugar levels, taking care of your diet, and exercising. In the midst of all this, we can sometimes forget about our eyes. But one of the most serious complications that can occur due to diabetes is vision loss. Among them, the most common and potentially vision-threatening condition is Diabetic Macular Edema, or DME for short. Hearing this name can be a bit scary. But don't worry. If you are properly informed about this and get treatment at the right time, you can protect your precious eyes.
Simply put, what is Diabetic Macular Edema (DME)?
Okay, let's put it this way. At the back of your eye, there's a very sensitive area that acts like the film in a camera. We call it the retina . The images we see are recorded on this retina. When you have diabetes, especially if your blood sugar levels are not controlled for a long time, the tiny blood vessels inside your eye begin to get damaged. Like an old water pipe, these blood vessels become weak and start to leak blood and fluid. We call this condition Diabetic Retinopathy .
Now, when this leaking fluid builds up in the retina, it starts to swell. There's a very important part of the retina that helps us see clearly, right in the middle, called the macula . When that leaking fluid builds up in the macula and it swells, that's what we call Diabetic Macular Edema (DME) . When the macula swells, it directly affects our sharp, clear vision.
Do you have symptoms like these?
One problem with DME is that it sometimes doesn't show any symptoms in the early stages. But as the condition progresses, you may notice things like:
- Blurred vision: When reading a book, watching TV, or looking at someone's face, the center of the image becomes blurry and unclear.
- Images appear stretched or wavy: Even a straight line can appear stretched like a wave.
- Faded colors: Colors appear to have lost their brightness and clarity, appearing "washed out."
If you have any of these symptoms, don't delay . See your doctor as soon as possible. If you have diabetes, it's important to have an eye exam at least once a year , even if you don't have any symptoms.
How does a doctor diagnose DME?
When you go to the doctor, he will first ask you a few questions and then do an eye exam.
Questions to ask the doctor
- Have you noticed any changes in your vision recently?
- How long have you been diagnosed with diabetes? Does anyone in your family have it?
- How are your blood sugar and A1c levels?
- Do you have high blood pressure or high cholesterol?
- Are there any other medical conditions?
After that, these tests are mainly performed during eye examinations.
| Name of the test | Simply put, what do you do with this? |
|---|---|
| Visual Acuity Test | This is the reading vision test we all know. It measures how clearly you can see at different distances. |
| Dilated Eye Exam | The doctor will put drops in your eye to enlarge the black hole in your eye. Then, using a special instrument, they will look inside your eye to check the condition of your retina, whether there is fluid leaking from the blood vessels, and whether there is any swelling. |
| Fluorescein Angiogram (FA) | This is a special test. A special dye is injected into a vein in your arm. As the dye travels through the blood vessels inside your eye, a special camera takes pictures. This can help pinpoint where the blood vessels are leaking. |
| Optical Coherence Tomography (OCT) | This is like a scan of the inside of the eye. A special camera takes a picture of a cross-section of the retina. This can very precisely measure how much swelling there is in the macula and how much fluid has accumulated. |
After these tests, the doctor will determine whether you have DME and how serious it is.
What are the treatments for DME?
Fortunately, there are now very effective treatments for DME. Your doctor will recommend the most appropriate treatment based on your condition.1. Anti-VEGF Injections
This is the main and most effective treatment currently available. VEGF is a protein that helps new and weak blood vessels form inside our eyes. These injections block that VEGF protein. This stops new blood vessels from forming and fluid from existing vessels from leaking out. These injections are injected directly into the eye. Although it may sound a little scary, it numbs the eye so it doesn't hurt much. The most commonly used medications are:
- Aflibercept (Eylea)
- Bevacizumab (Avastin)
- Ranibizumab (Lucentis)
- Faricimab-svoa (Vabysmo) - This is a new drug that blocks both VEGF and Ang-2 proteins.
2. Laser treatment (Laser Photocoagulation)
If the condition is more severe, lasers are used to "seal" or burn off the leaking blood vessels. This can help control the swelling. You may need to have several treatments.
3. Other treatments
In some cases, steroid injections are used. Also, if the fluid inside the eye (vitreous humor) is bleeding and causing blurred vision, a surgical procedure called vitrectomy is performed to remove the fluid and replace it with a clear solution.
Things you can do to take care of yourself
In addition to the treatments your doctor gives you, there are many things you can do yourself. Doing these things correctly can help prevent the condition from getting worse.
- Control your diabetes: This is the most important thing. Keep your blood sugar, blood pressure, and cholesterol levels at the optimal levels prescribed by your doctor. Take the prescribed medication exactly as prescribed.
- A healthy lifestyle: Eat a balanced diet, control your weight, and exercise daily. Talk to your doctor about this and come up with a plan that's right for you.
- Don't skip eye exams: Don't put off getting your eyes checked because you think there's nothing wrong. Your doctor will want to see you regularly to see how well your treatment is working and to check for any other problems.
- Consider your mental health: It's normal to feel sad and anxious when you have vision problems. Talk about your feelings with your family, a trusted friend, or your doctor. Seek help from a mental health counselor if necessary.
Remember, DME is a vision-preserving condition if detected early and treated properly. So don't be afraid, face it with courage.
Take-Home Message
- If you have diabetes, keeping your blood sugar, blood pressure, and cholesterol levels under control is the best way to protect your eyes.
- Even if you have no symptoms, be sure to have a complete dilated eye exam at least once a year.
- If you experience symptoms such as blurred vision, distorted images, or faded colors, see a doctor immediately.
- There are now very effective treatments for DME (Anti-VEGF injections, lasers). The earlier treatment is started, the greater the chance of preserving vision.
- You are not alone on this journey. Get support from your doctor, family, and friends.
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