Living with diabetes? Having trouble seeing clearly? You could have Diabetic Macular Edema.
What it is and what you can do about it.
1 in 3 Canadians are living with diabetes or prediabetes, making them up to 25 times more likely to experience vision loss. Recent figures show that more than 60,000 Canadians are living with Diabetic Macular Edema (DME) related vision loss, the leading cause of vision loss amongst people with diabetes. Fortunately, there are treatments available today that can help manage DME along with doctor-recommended lifestyle adjustments on what you can do to keep your eyes healthy.
It’s important that DME is caught as early as possible. Since many people with early DME do not experience vision loss right away, visiting an eyecare professional regularly is a key step to early diagnosis.
Dr. Peter Kertes, Professor and Chair of Ophthalmology and Vision Sciences at the University of Toronto, and Staff Ophthalmologist and Retinal Specialist at Sunnybrook Health Sciences Centre explains how DME affects the eye – and your vision.
“DME affects the retina, the tissue that lines the back of the eye. I think of it like the film in a camera; the retina is responsible for interpreting what’s out there and sending it to your brain as vision. With diabetes, the small blood vessels in the back of the eye can leak fluid, causing swelling in the retina. We call this Diabetic Macular Edema. DME can lead to blurred or decreased vision. It’s that swelling that we treat with various therapies.”
Typically, people with DME will not notice any visual symptoms until the central part of the retina, or the macula, is affected. Vision loss with DME is usually painless.
“The worst things that happen to the eye usually don’t cause any pain, and DME is no different,” says Dr. Kertes. “This can be a problem because oftentimes pain drives people to seek medical treatment. I’ve had patients with serious ophthalmic issues who waited a long time before seeking treatment because they thought the issues would go away on their own. Regularly visiting an eye doctor is especially important as it’s so difficult to screen for DME on your own.”
If you are living with diabetes, Dr. Kertes recommends visiting an eye doctor every two years. If you have DME, even at the earliest stage, it is important that you get treatment as early as possible. Treatments for DME are needed as often as once a month.
- Distorted vision (straight lines appear wavy)
- Difficulty seeing things in front of you
- Difficulty seeing colours
- Dark spots (scotomas)
Medical treatments for DME can include laser treatment and/or anti-vascular endothelial growth factor drugs (anti-VEGF). VEGF is naturally produced in the body, encouraging the leakage from and the formation of new blood vessels. Anti-VEGF treatments remove excess VEGF from the eye, helping to slow down vision loss. With laser surgery the leaking blood vessels are treated, stopping the leakage, and potentially lowering swelling in the retina.
“DME treatments are constantly progressing,” Dr. Kertes says. “In the 1980s, laser was the go-to treatment; now we rely on eye injections a lot more. Injections take about three seconds and it’s not uncommon to have patients, after the first injection, ask ‘is it already done?’
Most patients want to do whatever they can to keep their vision for as long as possible. Though eye injections sound terrible, I can promise you they are not so bad.”
While DME treatments are constantly progressing, protecting your vision takes more than just medical treatment.
“At its core, DME is a diabetes-related disorder,” Dr. Kertes says. “A DME diagnosis can be a wake-up call. Sometimes, people can get away with a lot for a long time. It’s easy to neglect blood sugar, blood pressure, and cholesterol concerns. A DME diagnosis can remind a patient to take charge of their lifestyle, to eat more healthily and be more active.”
What you can do to lower your risk of DME:
- Book regular eye exams
- Quit smoking
- Exercise regularly
- Maintain a healthy diet
Are you living with DME? Visit www.LivingWithIt.ca for more information and resources. Think you might be at risk? Schedule an appointment with an eyecare professional today.
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