Diabetic macular edema (DME) is a possible complication of diabetes. Over time, high blood sugar levels can cause damage to the tiny blood vessels in the eyes.
When the walls of these tiny vessels get damaged, they get weaker and may leak fluid or blood. When fluid gets into the retina’s center part, called the macula, it causes swelling. This can affect your vision and in some cases, lead to vision loss.
Regular eye exams are important to catch DME early. An eye doctor can look for signs of damage in your eyes. Damage can occur even before you notice any change in your vision.
Because there’s no cure for diabetes, DME often reoccurs. But treatment can prevent and slow vision loss and other complications related to DME. If you have DME, there are resources and supports that can help if you are living with vision changes.
There are a variety of tools and aids to help you do the things you need and want to do even with low vision.
Be aware of the level of light in your home. Consistent lighting matters — moving between light and dark spaces can be risky.
Here are some tips to keep your space well-lit:
- Keep lamps in spaces where you need extra light.
- Choose lamps that can swivel so you can focus the light where you need it.
- Consider getting a lamp with an internal reflector. It may be helpful for creating more light with less heat.
- Set up lighting in a way that reduces shadows. Hallways and bathrooms can be dark spaces, increasing your risk of a fall. Ensure that there’s enough lighting in those spots.
If you love to read but are having a hard time seeing small print, you have options:
- Buy or borrow books in large print.
- Use an e-reader. You can enlarge the print size, and they often have backlighting, which can be helpful.
- Download or borrow audiobooks.
A variety of magnifiers are available. They make small images and fonts bigger and more readable. Some are portable so that you can bring them grocery shopping or look at restaurant menus.
Other types connect to a screen at home, showing a larger image of what you are trying to read. These can be used for recipes, books, photos, or anything else you need to enlarge. You can find a good list of options here.
If you’re having trouble with daily tasks, ask your doctor about a referral to an occupational therapist (OT).
Some OTs specialize in helping people with low vision. An OT may be able to help you set up your home in a way to make it safer and easier for you to navigate with low vision. They can work with you to make everyday tasks easier.
There are also optometrists who specialize in what’s called vision rehabilitation or low vision. These optometrists often work together with OTs.
While an OT may teach you how to use the equipment and nonoptical aids, the optometrist will prescribe the low vision technology, such as magnifiers or glasses, that will work best for you. Low vision optometrists focus on practical ways to improve the quality of life of people with DME.
If you have DME, you may be seen by an ophthalmologist, specifically a retina specialist, for disease management, and also a low vision optometrist and OT as needed.
Living Well with Low Vision has a list of agencies on its website. Agencies are listed by state so you can find out what’s available in your area.
The site has lots of helpful articles about coping with low vision. There’s a detailed list of products to make daily tasks more manageable with low vision.
The National Federation of the Blind has chapters throughout the United States. This organization is a huge community of blind people across the country. They advocate for better support for blind people in schools, workplaces, and other settings.
If you love books, you can join the National Library Service through the Library of Congress. Membership allows you to access a huge collection of audiobooks and braille materials.
If you don’t have health insurance to cover the cost of eye exams, you may qualify for the EyeCare America program. The program provides access to free eye exams. Regular eye exams are important to watch for changes in your eye health. Cost should not be a barrier to protecting your eyes.
Support groups can be a way to meet other people who are living with low vision or blindness. Groups can be a chance to discuss the daily challenges of living with low vision. It’s also a great space to share ideas and resources.
The National Federation of the Blind has chapters throughout the United States. There may be a chapter near you. Consider joining your local chapter to connect with others at meetings in your area.
There may also be online support groups that you can join. Ask your healthcare professional if they know of other support networks in your area.
The longer that you live with diabetes, the greater the chances are that you may develop some eye disease. Not everyone with diabetes will develop DME.
There are things you can do to protect your eyes from damage.
If you’ve already been diagnosed with DME, you can slow the
- Do your best to keep blood sugar levels and A1C on target.
- Manage cholesterol and blood pressure levels.
- Have frequent eye exams.
Diabetes can be tough to manage. You may have trouble getting your blood sugar levels into the target range. Balancing blood sugar often involves diet, physical activity, and medications including insulin. Over time, you may change the way you manage your diabetes.
There are many ways to manage blood sugar. If your current approach isn’t working, talk with your doctor about what to do. There may be dietary changes that can help or it may be time to adjust or add medications.
Annual eye exams are important to monitor your eye health. In the early stages of DME, an eye doctor can see damage starting in your eye before you have any changes in your vision. There are
Treatments for DME include:
- anti-VEGF medications injected into the eye to reduce fluid leaking from blood vessels
- laser photocoagulation to close off leaking blood vessels
- steroid medications injected into the eye to reduce the swelling of the retina (if other treatments don’t improve symptoms)
Diabetic macular edema (DME) is a possible complication of diabetes.
It happens when high blood sugar levels cause damage to the tiny blood vessels in the eyes. It can affect vision and lead to blindness.
There are treatments to slow the progression, as well as a variety of tools and supports to help people living with low vision.
You can ask for support from your healthcare professional to find ways to adapt to life with low vision.