What is Diabetic Macular Oedema?

There are many different eye conditions which may bring the eye-opening news that your treatment is going to involve eye injections. Diabetic Macular Oedema is one of these.

The common feature of all these conditions is a build-up of fluid at the macula (the central part of the back of your eye).  This can occur in wet macular degeneration, following cataract surgery or after an ‘eye stroke’.

In terms of diabetes, some patients will develop swelling at the macula associated with diabetes changes at the back of the eye.  This has a special name: ‘Diabetic Macular Oedema (DMO)’.

Whether you’re 5 or 55, a trip to the doctor for an injection can make the heart race and the palms sweaty. Further, the thought of having an injection in the eye belongs to a whole new realm of scary!

Diabetes and Macula Swelling – Not so Swell

In patients who have diabetes, the blood vessels at the back of the eye can become leaky, causing haemorrhages and build-ups of fatty deposits (exudates) at the back of the eye. Sometimes the blood vessels can also leak fluid, which gathers at the macula, causing DMO.

A retinal photo showing diabetes changes of the retina

A retinal photo showing diabetes changes of the retina

When fluid builds up at the macula, it causes vision to become blurred.  If you have diabetes and notice a blurred patch right in the centre of your vision, you need to have it checked immediately!  If there is enough fluid at the macula, your eye doctor will likely recommend (brace yourself) a course of injections.

Treating Diabetic Macular Oedema with Eye Injections

The eye injections are a very efficient way to deliver medicine to the back of the eye. This will gradually dry up the fluid, hence improving vision!

Diabetic macular oedema can be slow to resolve and take a series of injections to clear.  Usually, to begin with, they will occur a month apart. They will then gradually reduce in frequency as the swelling at the macula improves.

So just how scary are these injections? Not very! And understanding the process can help to alleviate the fear around the procedure. Here’s how it’s likely to go down.

Step 1. Getting prepped

Before your injection, you will have your vision and eye pressure measured just like at the start of a regular eye test.  A special scan of the macula, an ‘OCT scan’, will then be taken.  This scan captures the area of fluid and allows your doctor to monitor how it is changing over time with the injections.  At KindSIGHT, we are fortunate to have the Heidelberg Spectralis OCT, the ‘Rolls Royce’ of OCT Imaging.  This is a very sensitive machine that helps us to detect very small changes in the fluid at the back of the eye.

Step 2. Dropped and ready

The next step is a series of eye drops to prepare you for the surgery.  These include:

  • pressure-lowering drops
  • anaesthetic drops
  • antiseptic drops and anti-inflammatory drops

All these drops help to numb your eye, protect from infection, keep the eye pressure low and reduce the risk of pain after the procedure.

Step 3. Injection Part 1

Confession alert:  one thing you probably weren’t bargaining on was TWO injections during the procedure! The first is an anaesthetic injection which delivers some medicine to further numb your eye. Because you have already had anaesthetic drops instilled, it is painless. You will be asked to look down towards your nose during this step, so you won’t even see the injection coming!

Step 4. Injection Part 2

After you have had the first injection, the second will be a piece of cake!  Your eye should be nice and numb by this stage, and again, you will be asked to look down towards your nose.  So you won’t see it, OR feel it, in fact, you may ask yourself afterwards if it even happened!

Step 5. The aftermath

Most people have a quick, painless recovery after their injection.  You will be given some lubricating eyedrops following your procedure.  It is very important to rest and use these drops frequently to allow the cells on the front of the eye to heal quickly and keep the eye comfortable.

Occasionally, if the eye is not well-lubricated, you may experience a sore eye for a couple of days following the injection.  This is easily treated with lubricating eye drops, and before you know it, your eye will be feeling as good as gold again!

If you have diabetes and experience any concerning changes in your vision, schedule an appointment with Dr Smallcombe and the team for a consultation today.