Macular edema is a diagnosis which presents when there is fluid build up in the macula the central part of the retina that is responsible for sharp vision. This can cause issues like difficulty in reading, recognizing faces, and seeing fine details. As this retinal issue may present itself due to diabetes, blood vessel disorders, or inflammation, any new changes in central vision should be evaluated by an ophthalmologist.
Understanding the Condition
The macula which is the part of the eye responsible for our sharp central vision may be described as swollen in macular edema which is what this condition is basically. People do at times look for info on which the term ‘fluid in eyeball’ is used but that is a misrepresentation of what really happens. From the National Eye Institute’s clinical report we learn that what happens is leakage from the retinal blood vessels which in turn causes the macula to swell and which in turn causes blurring of central vision.
In diabetic clinically significant macular edema a typical term which we use is for when retinal thickening or hard exudate s appear near the macula. At present we also look at whether there is involvement of the macula’s center as this may play a role in how we manage the patient.
Macular Edema Symptoms
Macular edema symptoms at first may present with very mild signs. A person may see that central vision is blurred, color appears duller, or they have trouble with fine print. Also if macular edema is in only one eye the change may be masked by the use of the stronger eye.
| Vision change | What it may feel like |
| Central blur | Words, faces or details appear less sharp |
| Distortion | Straight lines may look bent or wavy |
| Reduced contrast | Colours or objects may look faded |
| Central dark area | A spot interferes with detailed vision |
These changes don’t in and of themselves diagnose the condition. Also other retinal diseases may present with the same symptoms which is why a dilated eye exam is very important.
Main Causes
Common macular edema causes are diabetic retinopathy, retinal vein occlusion, intraocular inflammation, wet age related macular degeneration and swelling post certain eye surgeries. Damaged retinal blood vessels may leak out causing retina swelling and also in some cases inflammation produces macular oedema.
Diabetes is a large risk factor which over time causes damage to small retinal vessels. Upon leakage to the macula which it does so before other symptoms present themselves, macular edema may affect central vision. Thus it is very important for diabetics to have regular retinal exams.
How Is It Diagnosed?
A doctor will start with a visual acuity test and a dilated retinal exam. In a macular edema fundus evaluation the ophthalmologist looks for retinal thickening, deposits, bleeding and other signs. macular edema work up also includes optical coherence tomography which is known as OCT that produces cross sectional retinal images and also measures fluid and thickness.
| Test | What it helps assess |
| Dilated fundus examination | Macula, retinal vessels and surrounding retina |
| OCT | Retinal thickness and location of fluid |
| Fluorescein angiography | Areas of blood-vessel leakage |
| Amsler grid | Distortion or gaps in central vision |
Also as reported by the NCBI Bookshelf clinical review they note that OCT and fluorescein angiography are very common in the evaluation of retinal swelling and in the investigation of what is causing it.
Macular Edema Treatment
Macular edema treatment varies by cause, severity and degree of vision effect. In the case of macular edema brought about by diabetes or retinal vein occlusion we see very frequent use of anti-VEGF injections. In some cases of inflammation or what is a persistent issue, steroids may be used but also which play a role are laser treatment and surgery for specific issues.
There is not a one size fits all approach to retinal swelling treatment. In some cases we do monitoring, in others we go in for repeat injections or we treat the root cause. When diabetes is a factor in retinal edema we still see that it is important to control blood sugar, blood pressure and cholesterol.
At Vasan Eye Care we present a range of retina services as well as eye test and eye specialist assessment which we use to determine the cause of macular edema and which treatment path is best for you. Presenting with a sudden change in central vision, new distortion or a dark spot in the center should be brought in for evaluation as soon as possible.
Why Early Evaluation Matters
Persistent macular edema may cause impairment of the retina and also lead to permanent loss of central vision. In what is to come it’s key to have an early diagnosis and continuous follow up of the case and issue.
Frequently Asked Questions
1. Can this condition be treated successfully?
Macular edema is at times reduced or controlled, also it is to great degree a product of the cause and response to treatment.
2. What is the usual treatment for macular edema?
Treatment which may include anti-VEGF injections, steroids, laser, surgery or watchful waiting is based on the diagnosis.
3. Is macular edema the same as retinal swelling?
Macular edema is a condition of retinal swelling which in turn affects the macula that is responsible for detailed central vision.
4. When should I see an eye doctor?
See eye care professionals immediately for new central blur, wavy vision, a dark spot or sudden change in vision.
References Links
- National Eye Institute – Macular Swelling Overview
https://www.nei.nih.gov/eye-health-information/eye-conditions-and-diseases/macular-edema - NCBI Bookshelf – Clinical Review of Retinal Fluid and Swelling
https://www.ncbi.nlm.nih.gov/books/NBK576396/