Swelling in the macula (macular edema) can result from numerous conditions. Over time, untreated swelling can cause blurry vision or permanent vision loss.
Your retina is the thin layer of tissue at the back of your eye that turns light into signals your brain can process. The macula is the central zone of your retina, where your most precise vision occurs — the type of vision necessary for activities such as reading and driving.
Macular edema happens when the macula swells.
Read on to learn more about what symptoms of macular edema to watch out for, what the most common causes of macular edema are, and how macular edema can be diagnosed and treated.
Blurry vision that gets worse over time is the most common symptom of macular edema.
Blurriness doesn’t always interfere with your daily activities. But macular edema can make it hard to read, drive, or perform detail-oriented tasks that require looking forward.
Other common symptoms of macular edema in one or both eyes include:
- waviness in your vision
- colors looking faded
- unusual changes in how you see the sizes of objects
Some causes of macular edema are mild and temporary, but others are serious and may need medical attention.
Diabetic retinopathy happens when high blood sugar levels damage blood vessels in your eye. This damage can cause the blood vessels to swell and seep fluid into the macula.
Along with blurry vision, other common symptoms of diabetic retinopathy include:
- vision that seems to get better but then gets blurry again
- spots or long, stringy objects floating in your vision
- loss of sight in specific areas of your visual field, causing you to see dark spots
- floating spots or dark strings in your vision
- loss of vision over time
Macular degeneration results from the lifelong buildup of metabolic waste products beneath your photoreceptors. Atypical blood vessels under the macula leak fluid into the macula and cause swelling.
Symptoms of macular degeneration include:
- losing vision when you look straight ahead
- noticing haziness in your visual field
- seeing lines as blurry or distorted
- having trouble seeing in dim lighting
- needing very bright lights to see well
- having difficulty seeing people’s faces
Retinal vein occlusion
In the short term, obstructed flow of blood and other fluids can cause acute macular edema. Over time, the starving retina will stimulate proliferation of abnormal blood vessels that can result in chronic macular edema.
RVO can result from aging, but it can also be a complication of diabetes or glaucoma.
Symptoms of RVO can include:
Retinitis pigmentosa (RP)
RP is a condition that increases the risk of retina damage from certain medications, infections, or injuries due to gene mutations.
Symptoms of RP include:
- trouble seeing in low or dim lighting
- trouble adjusting vision from dim to bright lighting
- loss of peripheral vision along the top, bottom, and sides of your visual field (tunnel vision)
- loss of the ability to tell colors apart
Inflammation or damage to eye tissues after surgery can cause swelling in the macula, leading to blurry vision and other symptoms of macular edema.
Macular edema isn’t always serious. Depending on its cause, it may fully resolve with eyedrops or on its own. An eye specialist can determine whether treatment is necessary.
If you do not receive the recommended treatment, macular edema can sometimes result in:
- permanent blurry vision
- permanent changes to your visual field or peripheral vision
- permanent blindness
Contact a doctor if you notice any severe symptoms of macular edema, such as:
- blurry vision that gets worse over time
- loss of vision
- intense pain or pressure in your eye
- difficulty seeing well enough to do daily tasks such as driving and reading
An eye doctor can look for eye swelling during an exam.
The doctor may also use other tests, such as:
- a fluorescein angiogram, which involves injecting dye into your arm to make the blood vessels in your retina more visible in imaging
- optical coherence tomography (OCT) to get detailed images of your retina and determine where swelling is
- an Amsler grid to see whether straight lines on a grid look dark, wavy, or blurry to you
Here are some common treatment options for macular edema.
Anti-VEGF injections can help slow the progression of macular edema over time.
Steroid injections can reduce retinal swelling that can cause macular edema. A miniature long-acting steroid device can also be implanted inside your eye.
Eye drops containing nonsteroidal anti-inflammatory drugs can reduce pain and swelling associated with macular edema.
Eye drops may be used along with steroid eye drops to reduce inflammation.
A doctor can perform laser treatment after RVO in areas with inadequate blood supply (retinal ischemia) and in areas where persistent leaking vessels appear. This treatment is usually recommended if injections or eye drops haven’t helped treat your symptoms.
A doctor may recommend a surgical procedure called a vitrectomy to remove the clear, gelatinous vitreous fluid that fills the inside of your eye. It’s considered a highly effective surgery that can help reverse the symptoms of macular edema and remove old blood and cellular debris. Sterile fluid is used to replace the vitreous fluid.
There are no specific at-home treatments for macular edema.
However, tips for helping reduce the symptoms of macular edema include:
- wearing glasses
- using a magnifying glass
- taking vitamin supplements such as vitamin C or E
- eating less beta carotene
- quitting smoking, if applicable — this can be difficult, but a doctor can create a plan that works for you
- taking steps to lower your blood pressure
- making efforts to reach or maintain a moderate weight
- lowering your cholesterol levels
- getting at least 30 minutes of exercise each day
Here are some of the most frequently asked questions about macular edema.
Is macular edema serious?
Not always. Macular edema can be a natural result of aging and may not be very disruptive to your life. But some causes, such as diabetes and autoimmune conditions, can be serious and need medical attention.
Can macular edema heal itself?
Yes, macular edema sometimes heals itself without needing medical treatment. But it’s recommended that you contact a doctor if blurry vision gets worse over time.
Macular edema can cause temporary vision changes and resolve with time, but in some cases, it can be very serious. If you’re experiencing new or worsening vision-related symptoms, contact an eye doctor for a comprehensive evaluation and diagnosis.