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Diabetic. Getting blurred vision. Found macular edema in eye. Should I be concerned?

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My younger sister, XXXXXXX saw her eye doctor today and he ran some tests and found that she has macular edema in her left eye. She says she has no issues in her right eye. She was complaining of blurred vision in the left eye and says she has no 'central vision' in her left eye. XXXXXXX has Type 1 diabetes. The eye doctor was not sure if it was diabetes related because she only has it in one eye and said people with diabetic macular edema generally have issues with both eyes.

My parents are out of the country, so I am responsible for my sister, and am very concerned about this. She is seeing a retina specialist on Tuesday in order to determine treatment, etc... Her diabetes has been a little bit out of control the past few years as far as her blood sugar levels. I don't think she takes great care of her diabetes.

How concerned should she be? She is nervous she won't gain back the sight she lost. Also, what is the best treatment option? I understand that without seeing her in person, you probably can't provide me with a detailed course of action. But I'm basically looking for good questions I can ask the retina specialist, best treatment options, what she can be doing on her end to improve the symptoms, and general information on the severity of this issue. Also, do you think it's macular edema or diabetic macular edema? From what I've read online, the diabetic version looks much worse??

The more information you could provide me the better because I don't live in her city and will be flying in to accompany her to the Tuesday appointment.
I forgot to mention, but just to add, her vision was 20/20 with her glasses in an appointment with her eye doctor 5 months ago, and all of these symptoms just started in the past few days.

Thanks is advance for your help.

Posted Sat, 11 May 2013 in Vision and Eye Disorders
Answered by Dr. Mihir Shah 2 hours later

Thanks for the query.

From your description it may be diabetic macular edema. Diabetic macular edema can occur in one eye.

Diabetic retinopathy and macular edema are detected during a comprehensive eye exam that includes:

Visual acuity test. This eye chart test measures how well you see at various distances.
Dilated eye exam. Drops are placed in your eyes to widen, or dilate, the pupils. This allows the eye care professional to see more of the inside of your eyes to check for signs of the disease. Your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of damage and other eye problems. After the exam, your close-up vision may remain blurred for several hours.
Tonometry. An instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test.

Your eye care professional checks your retina for early signs of the disease, including:

Leaking blood vessels.
Retinal swelling (macular edema).
Pale, fatty deposits on the retina--signs of leaking blood vessels.
Damaged nerve tissue.
Any changes to the blood vessels.

If your eye care professional believes you need treatment for macular edema, he or she may suggest a fluorescein angiogram. In this test, a special XXXXXXX is injected into your arm. Pictures are taken as the XXXXXXX passes through the blood vessels in your retina. The test allows your eye care professional to identify any leaking blood vessels and recommend treatment.

Your eye care professional may also recommend OCT(Optical Coherence Tomography) which is a device which measures the amount of fluid collection in the macula.

Macular edema is treated with laser surgery. This procedure is called focal laser treatment. Your doctor places up to several small laser burns in the areas of retinal leakage surrounding the macula. These burns slow the leakage of fluid and reduce the amount of fluid in the retina. The surgery is usually completed in one session. Further treatment may be needed. Sometimes prior to laser treatment you may be advised to take an eye injection to dry up the excess fluid.

A patient may need focal laser surgery more than once to control the leaking fluid.

Focal laser treatment stabilizes vision. In fact, focal laser treatment reduces the risk of vision loss by 50 percent. In a small number of cases, if vision is lost, it can be improved.

Hope your sister does fine.

Best regards,
Dr.Mihir Shah
Above answer was peer-reviewed by
Follow-up: Diabetic. Getting blurred vision. Found macular edema in eye. Should I be concerned? 1 hour later
Thanks for the response. She is only 23 years old, what would be her long term prognosis after laser surgery? Would her sight or condition continually get worse over time if she does in fact have macular edema? Also, what do you mean by 'In fact, focal laser treatment reduces the risk of vision loss by 50 percent?' Does this mean that she would lose at least 50% of her vision?
Answered by Dr. Mihir Shah 13 minutes later
Thanks for writing back.
After the laser treatment, if she keeps her diabetes well under control then the long term prognosis is good. If she undergoes laser treatment, her chances of losing her vision are reduced to half (50%) even if she does not control her diabetes. In short laser treatment is helpful in preserving vision.

Best regards,
Dr.Mihir Shah
Above answer was peer-reviewed by
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