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What Is Macular Edema?

The macula is the central portion of the light-sensitive lining of the back of the eye, called the retina. When fluid builds up in the macula and causes swelling, it is referred to as macular edema.

What are the Symptoms of Macular Edema?

The macula is responsible for the majority of clear, central vision, so a disruption in its normal functioning can result in:

  • Reduced visual acuity
  • Distorted central vision
  • Color distortion

Symptoms can vary in severity and duration. If the fluid appears suddenly, the impact on the vision can be immediate. Occasionally, the fluid can build up slowly, taking years for a person to be aware of the signs, as they may not be noticeable until the edema has advanced considerably.

What Causes Macular Edema?

Any disease or condition that damages the body’s blood vessels, that causes them to leak fluid or blood, can contribute to or cause macular edema. They include:

Diabetic Macular Edema

Diabetic macular edema (DME) is one of the most common causes of macular swelling and is a side effect of diabetic retinopathy — retinal disease specific to diabetics. Approximately 745,000 Americans have diabetic macular edema, but over half of them don’t know it yet.

Elevated blood sugar levels can cause the delicate blood vessels in the retina to weaken. As a result, the thinned blood vessel walls become more permeable to fluid and begin to leak fluid or blood into the retinal tissue.

This type of macular edema usually occurs in both eyes and will worsen with prolonged uncontrolled blood sugar levels. DME is the leading cause of blindness in patients with diabetic retinopathy and can occur at any stage of diabetes.

Age-Related Macular Degeneration (AMD)

Macular degeneration occurs when the macula begins to break down, usually as a result of aging. In a severe form of AMD called ‘wet AMD,’ abnormal blood vessels grow underneath and through the retina and may leak blood or fluid into the macula. There are approximately 200,000 new cases of wet AMD each year in the United States.

Eye Surgery

Any surgery that is performed inside the eye can lead to macular edema. Examples include cataract surgery, glaucoma surgery and surgical procedures used to treat retinal disease.

Eye surgery can place pressure on the delicate retinal blood vessels, which can lead to their damage and leakage.

Retinal Vein Occlusion

Retinal vein occlusion occurs when the veins in the retina are blocked. This eye condition affects more than 1.1 million Americans and is a leading cause of vision loss caused by retinal vascular disease.

One consequence of retinal vein occlusion is poor fluid drainage and fluid buildup in the macula. The blocked vein causes increased pressure inside the blood vessel, leading to damage and fluid leakage. The severity of this type of macular edema largely depends on how many blood vessels are blocked, the blood pressure within the blood vessels and the degree of blockage.

Conditions that are associated with retinal vein occlusion: diabetes, atherosclerosis, hypertension and glaucoma.

Uveitis

Uveitis is a group of inflammatory eye diseases that cause swelling within the eye and destroy healthy ocular tissue. Macular edema is the most common cause of uveitis-associated sight loss.

How is Macular Edema Treated?

Treatment for macular edema will vary depending on what’s causing it. In most cases, it is essential to treat the underlying health problem, such as uncontrolled blood sugar or hypertension, as this may help stabilize, reduce or perhaps even eliminate the macular swelling.

Your eye doctor may advise treating the macular edema itself by sealing off the leaking blood vessels in the retina with a laser or injecting medication into the vitreous humor of the eye to stop the growth of abnormal blood vessels.

If these treatments are required, you will be referred to an ophthalmologist or retinal specialist for further investigations and treatment.

If the macular swelling is caused by eye inflammation, your eye doctor may prescribe anti-inflammatory medications either in the form of eye drops, pills or injections.

How We Can Help

Our practice is dedicated to keeping your eyes healthy, no matter what condition you may have. At Dolman Eyecare Centre, we treat a wide range of eye conditions and diseases, including macular edema and conditions that increase the risk of developing it.

We use the latest in diagnostic and therapeutic technology to ensure that you receive the best possible outcome. If you or a loved one have been diagnosed with macular edema or experienced any of its signs, contact Dolman Eyecare Centre to schedule a consultation.

Our practice serves patients from Kitchener & Waterloo region, Cambridge, Guelph, and Stratford, Ontario and surrounding communities.

References

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How to Prevent Diabetic Retinopathy

Diabetic retinopathy (DR) is one of the leading causes of vision loss around the world. Of an estimated 285 million people with diabetes mellitus worldwide, approximately one-third have signs of diabetic retinopathy.

Fortunately, there are several steps people with diabetes can take to prevent or minimize vision loss.

What is Diabetic Retinopathy?

Diabetic retinopathy is an eye disease caused by high blood sugar levels that damage the small blood vessels clustered within your retina. This leads to swelling or fluid leakage and can result in vision loss and even blindness.

Diabetic retinopathy also raises the risk of retinal detachment and/or glaucoma.

Because the early stages of diabetic retinopathy tend to be symptom-free, permanent retinal damage may occur before any obvious signs are noticed and the disease is diagnosed.

Ways to Prevent Diabetic Retinopathy

There are a number of ways to preserve your vision and reduce the risk of vision and eye damage due to diabetic retinopathy.

Visit your eye doctor for annual eye exams

In its early stages, diabetic retinopathy typically does not present any noticeable symptoms. Therefore, it’s crucial for people with diabetes to have annual comprehensive eye exams in order to identify the disease long before symptoms appear.

During a comprehensive eye exam, your eye doctor will use special imaging technology and diagnostic tools to evaluate your retina, optic nerve and macula.

Control your blood sugar

Diabetes prevents the body from adequately storing and using sugar, resulting in an accumulation of sugar in the bloodstream. High blood glucose levels damage blood vessels all over the body, including your eyes.

To protect your eyes from injury and vision loss, it’s critical to keep your blood sugar levels under control.

Maintain healthy cholesterol levels and blood pressure

Maintaining healthy cholesterol levels and blood pressure will not only help keep your heart healthy but your eyes as well.

Speak with your doctor to learn about the most effective ways to maintain a safe and healthy level of cholesterol and blood pressure.

Exercise

We all know that exercise is good for our physical and emotional health. For those with diabetes, it is all the more important, as routine physical activity helps control and reduce blood sugar levels.

Please note that you should always consult your doctor before starting any new exercise regimen.

Quit smoking

Smoking is particularly dangerous for those with diabetes. Here’s why:

  1. When exposed to high levels of nicotine, the insulin that lowers your blood sugar becomes less effective. You may thus require higher insulin doses to maintain blood sugar levels.
  2. Smoking induces oxidative stress, which occurs when smoke-derived chemicals react with oxygen in the body. This, in turn, damages the cells in your body and eyes.
  3. Cigarette smoking disrupts normal cell function and induces inflammation. When blood vessels that are swollen, they are more likely to burst and cause fluid to leak into the retina, resulting in ocular damage and vision loss.

As you can see, it’s critical to quit smoking— and not just for the body, but also for the eyes. We highly recommend that you seek out professional guidance on the most effective ways to kick the habit.

If you have diabetes, you are at risk of developing diabetic retinopathy. To reduce your risk and protect your vision, schedule an eye exam with Dolman Eyecare Centre today.

Our practice serves patients from Kitchener & Waterloo region, Cambridge, Guelph, and Stratford, Ontario and surrounding communities.
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The 4 Stages of Diabetic Retinopathy

Diabetic retinopathy is an eye disease that develops when high blood sugar damages the tiny fragile blood vessels in the retina of people living with diabetes.

This progressive eye disease may lead to blurred vision or even irreversible vision loss. Regular eye exams are important, because, by the time noticeable symptoms appear, vision loss may have occurred. The sooner your eye doctor can diagnose diabetic retinopathy, the sooner you can take steps to slow its progression.

What Are the Stages of Diabetic Retinopathy?

There are two types of diabetic retinopathy, which progresses in four stages.

The two types of diabetic retinopathy are nonproliferative and proliferative. Nonproliferative refers to the early stages of the disease, while proliferative is an advanced form of the disease.

Stage 1: Mild nonproliferative diabetic retinopathy

This is the earliest stage of diabetic retinopathy, characterized by tiny swellings/bulges in the blood vessels of the retina. These areas of swelling are known as microaneurysms.

These microaneurysms can cause small amounts of fluid to leak into the retina, triggering swelling of the macula – the back of the retina. Despite this, there are usually no clear symptoms indicating there is a problem.

Stage 2: Moderate nonproliferative diabetic retinopathy

At this stage, the tiny blood vessels further swell up, blocking blood flow to the retina and preventing proper nourishment. This stage will only cause noticeable signs if there is a build-up of blood and other fluids in the macula, causing vision to become blurry.

Stage 3: Severe nonproliferative diabetic retinopathy

During this stage, a larger section of blood vessels in the retina becomes blocked, causing a significant decrease in blood flow to this area. The lack of blood triggers a signal to the body to start growing new blood vessels in the retina.

These new blood vessels are extremely thin and fragile and cause retinal swelling, resulting in noticeably blurry vision, dark spots and even patches of vision loss. If these vessels leak into the macula, sudden and permanent vision loss may occur. At this stage, there is a high chance of irreversible vision loss.

Stage 4: Proliferative diabetic retinopathy

At this advanced stage of the disease, new blood vessels continue to grow in the retina. These blood vessels, which are thin and weak and prone to bleeding, cause scar tissue to form inside the eye. This scar tissue can pull the retina away from the back of your eye, causing retinal detachment. A detached retina typically results in blurriness, reduced field of vision, and even permanent blindness.

What Are Common Symptoms of Diabetic Retinopathy?

During its first two stages, diabetic retinopathy doesn’t usually cause obvious symptoms, so it’s possible to have it and not even know it.

Unfortunately, many people don’t have symptoms until the disease progresses to the proliferative diabetic retinopathy stage.

However, an eye examination by your [eye doctor] can detect diabetic retinopathy in its earlier stages, before symptoms become noticeable and damage has become irreversible.

Symptoms of proliferative diabetic (stage 4) retinopathy include:

  • Blurry vision
  • Change in colors
  • Decrease in field of vision
  • Distorted vision
  • Increase of eye floaters
  • Loss of vision
  • Poor night vision

How to Treat Diabetic Retinopathy

While diabetic retinopathy may lead to irreversible vision loss, successfully managing your blood sugar levels can help prevent loss of vision. This includes watching your diet, increasing physical activity, and taking diabetes medication as directed.

Other treatments depend on the stage or extent of the disease. If caught very early — before damage to the retina occurs — blood sugar management might be the only treatment necessary.

If you’re in a nonproliferative stage but experience some eye damage, treatment options might include:

  • Eye injections – A steroid injection in the eye to stop inflammation and prevent new blood vessels from forming. Anti-VEGF injections may also be recommended, which can reduce swelling in the macula and improve vision.
  • Laser surgery – Laser surgery called photocoagulation reduces swelling in the retina and removes abnormal blood vessels.
  • Vitrectomy – If you are in the later stages of diabetic retinopathy, you might need a vitrectomy. This eye surgery treats problems with the retina and vitreous, a jelly-like substance in the middle of the eye. The surgery can remove blood or fluid, scar tissue, and some of the vitreous gel so light rays can focus properly on the retina. Retinal detachments can be corrected at the same time.

Diabetic retinopathy is a potentially serious eye disease that can result in permanent distorted vision or vision loss. Preserve your vision by contacting Dolman Eyecare Centre to schedule your comprehensive eye exam today.

Our practice serves patients from Kitchener & Waterloo region, Cambridge, Guelph, and Stratford, Ontario and surrounding communities.
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