Diabetic Macular Edema occurs when there is a buildup of fluid in the eye. The fluid accumulates in the retina, particularly the macula. This is the area of the eye that allows us to have a precise, detailed vision. Therefore, when the fluid buildup occurs, usually due to damage in the blood vessels causing them to leak, individuals often experience vision loss. Who is most likely to experience DME? 
Diabetics are the most likely to experience DME, with approximately 28% of diabetics contracting some degree of DME in their lifetime. Certain health complications can increase the likelihood of experiencing DME, including having had diabetes for a long time, high blood pressure, low protein levels. Body fluids, fluid retention, high-fat levels, or poorly controlled blood sugars. 

What kinds of DME are there? 
There are two kinds of DME, focal and diffuse DME. Focal DME occurs when there are abnormalities in the blood vessels in the back of the eye, while diffuse DME is due to a widening/swelling of the retinal capillaries, causing them to become very thin.

What does DME look like? 
Most people who are suffering from DME will have blurry vision. Additionally, their vision will lack detail and might have floaters. Some people experience double vision as well. If left untreated, these symptoms can worsen and lead to blindness. 

What can be done for DME?
Luckily, in today’s world, there are options for treating DME and keeping it from progressing. Most people opt to have laser eye procedures that target and stop the leakage of fluid into the eye. This procedure will keep DME from progressing and thus further vision loss but is unlikely to reverse any previous damage to the eye. Other non-surgical treatments for DME can include steroids to lessen swelling in the retina. This is usually done orally, with a shot, or with a small implant in the eye.
 
What can I do to prevent DME? 
If you are diabetic, you should make sure to schedule and keep regular appointments with your eye care specialist. These should be done at least once every year, or more often at your doctor’s recommendation. If you have any other complications with your diabetes or a history of uncontrolled (especially high) blood sugars, you are at a higher risk for developing DME and should make sure that your eye care specialist is aware and appraised as to their development. Each appointment should include a dilation where your doctor looks into the back of your eye and assess the blood vessels for damage and can view the retina to see if there is any fluid buildup. If your specialist sees any fluid, they will be able to do a fluorescein angiogram, which takes pictures of your retina using a dye that will show any blood vessels that are leaking. Keeping blood sugars under control and managing other health issues that are co-morbidities for DME will help decrease the likelihood that you will experience DME and subsequent vision loss. 

My son has type 1 diabetes, and my mom has type 2, who is more at risk? 
Both type one and type two diabetics with high hemoglobin A1C tests are at risk for DME.
Type one diabetics are insulin-dependent and tend to be able to have more precise control over their sugars day to day but have more fluctuation.
Type two diabetics are diet controlled and tend to have less fluctuation, even if their blood sugars are not as high or low as a type one’s blood sugar at any given time. Having a lower average blood sugar and tighter control will help diabetics avoid complications. 
As always, if you have any questions then please call our offices. Your local Eye Center of Tennessee will be more than happy to answer any of your concerns.