Left unmanaged, this diabetes-related complication can lead to vision changes. Implementing the right strategies can help you protect your eyesight.

When high blood sugar levels related to diabetes cause damage to the blood vessels in the retina, it’s known as diabetic retinopathy. One complication of diabetic retinopathy is that blood and fluid can leak into the retina. An accumulation of fluid in the middle of the retina (macula) is called diabetic macular edema (DME).

Early on, you may not have noticeable symptoms. Then, as the macula swells, your vision can start to blur. DME is a leading cause of vision loss worldwide. But with treatment, you may be able to reduce swelling and prevent vision loss.

Learning you have DME can trigger a lot of concerns. The best way to address these concerns is to speak with your eye care or diabetes specialist. These are the questions you may want to ask at your next checkup.

Among people with diabetic retinopathy, about half will go on to develop macular edema. There’s no cure, but you may be able to slow disease progression.

One key factor is how soon you get a diagnosis. Vision loss is more likely when DME is already severe at diagnosis. Diabetes and high blood pressure control are also important prognostic factors.

Your doctor will be able to give you a better idea of what to expect based on your circumstances.

Without treatment, macular edema can lead to permanent vision loss. However, vision loss is not guaranteed.

About 25% to 30% of people with clinically significant macular edema will experience at least some vision loss within 3 years. For some people, mild blurry vision is the main symptom. But DME can also cause:

  • objects to look wavy
  • colors to look faded
  • severe central vision loss

Early detection and treatment can help lower the risk of permanent vision loss.

Your doctor will consider the specifics of your diagnosis before making treatment recommendations. Treatment options for DME include:

  • Anti-vascular endothelial growth factor (anti-VEGF) drugs: These drugs help limit leakage from abnormal blood vessels and stop new blood vessels from forming. After numbing the eye, a specialist injects the drug into or near the eye. It usually requires several treatments.
  • Laser treatment: Laser lights help close and destroy leaky blood vessels. It also helps slow or stop new blood vessels from forming. Your doctor will use special instruments to hold your eye open and keep your head still while applying the laser therapy directly into the damaged area.
  • Corticosteroids: These treatments are used to help reduce inflammation and swelling in the eye. They’re available as eye drops, tablets, or injections in or around the eye.
  • Surgery: In a procedure called vitrectomy, the surgeon removes vitreous gel and blood from the back of your eye. This allows light to reach the retina again. If scar tissue is found on the retina, it can be removed during this procedure.

Be sure to ask about the potential benefits, side effects, and risks of any treatment your doctor recommends.

Will treatment help improve my vision?

According to the American Diabetes Association, treating macular edema can sometimes stop or reverse vision loss. Each case is different, so your doctor will be able to explain whether that’s a possibility for you.

Maintaining good diabetes management can help slow the progression of macular edema. This includes:

  • keeping blood sugar levels in your target range as much as you can
  • controlling blood pressure and cholesterol levels
  • quitting smoking (ask your doctor about smoking cessation programs if you need help quitting)
  • being active to improve diabetes management as well as your overall health

Check in with your doctor to discuss specific steps that can help you manage your health and protect your vision.

Early on, blurry vision may be the only symptom of macular edema. As DME progresses, you might start to notice:

  • dark spots and floaters
  • objects that seem to move, disappear, or change shape, size, or color
  • straight lines that look distorted
  • colors that look dull or faded
  • light sensitivity
  • loss of peripheral vision
  • loss of central vision
  • visual images of things that aren’t really there (visual hallucinations)

Contact your eye specialist if you have any sudden or concerning change in your vision.

Along with DME, having diabetes also increases your risk of developing eye issues like cataracts or glaucoma. Your doctor can go over your risk factors and suggest a screening schedule.


A cataract is a cloudiness over the clear lens in the eye. Other risk factors for cataracts include high blood pressure, obesity, smoking, and too much sun exposure over time.

Symptoms of cataracts include:

  • blurry vision
  • fading colors
  • light sensitivity
  • trouble seeing at night
  • double vision


Glaucoma damages the optic nerve, usually due to excess pressure in the eye. The risk of glaucoma increases with age. Symptoms develop slowly, typically starting with poor peripheral vision.

If you have DME, your doctor will recommend a schedule based on the severity of symptoms and which treatments you choose. In some cases, you may need to start by having your eyes checked every 1 to 3 months.

There’s no cure for DME. But with the right information, you can take steps to lower your chances of permanent vision loss.

Make a list of questions to ask your doctor before your next visit so you don’t forget anything. Don’t hesitate to ask follow-up questions if there’s anything you don’t understand. Knowing what to expect can help you feel better about DME and how it’s treated.