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Diabetic macular oedema

Diabetic eye disease is a leading cause of blindness registration among working age adults in England and Wales. 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.

  • 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.

  • All people with type 1 and type 2 diabetes are at risk of diabetic macular oedema.
    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.
    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
    • Have high blood pressure
    • Have high cholesterol levels
    • Smoking
    • Are pregnant

    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.

  • 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. This can be achieved by regular visits to your diabetes nurse, general practitioner or consultant.

    Your consultant will be happy to discuss any aspects of your diabetes management.

  • 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 a medical retina consultant at Moorfields Private for further assessment.

  • In the early stages of diabetic macular oedema, no treatment is needed.

    If treatment is required, the treatments for diabetic macular oedema are:

    1. Laser therapy
    2. Injection therapy

    Laser therapy?

    A laser is used to produce small burns on areas of leaking blood vessels in the macula. Usually, laser burns are applied over several sessions. The goal of laser therapy is to reduce the amount of fluid in the macula. Several sessions may be required to achieve this. The full effects of laser therapy only occur after several months. This is why you may be asked to return to clinic three or four months after laser therapy. Studies have shown that laser therapy reduces the risk of visual loss by 50%. The aim of laser therapy is to stabilise your vision. Improvement in vision only happens in a small number of cases.

    Injection therapy?

    This treatment involves the injection of medication into the eye. The drug works by reducing fluid leakage from blood vessels around the macula. This in turn reduces swelling of the macula. Studies have shown that this treatment is effective in preventing visual loss and can improve vision in some patients. A course of injections is required to treat diabetic macular oedema. At the start of treatment, usually one injection per month is needed. It is important to attend all appointments while receiving injection therapy. This treatment will not work if you do not have the injection at a regular interval. The length of time between injections, and how long you will need to stay on injection therapy will depend on how you respond to the treatment.

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Diabetic macular oedema consultants

A picture of Mr Bishwanath Pal

Mr Bishwanath Pal


Consultant Ophthalmic Surgeon

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