DME Eye Exam | Diabetic Macular Edema Doctor

An eye exam for diabetic macular edema includes screenings that provide detailed images of the retina and the tiny blood vessels in this area at the back of the eye. A special type of vision test also may be performed to check for central vision loss. 

Diabetic macular edema (DME) is the most common cause of vision loss among people with diabetic retinopathy, a complication of diabetes that affects the blood vessels in the back of the eye. However, if your doctor diagnoses diabetic macular edema and begins treatment promptly, you may be able to prevent or reduce vision loss associated with this condition. 

Learn what to expect during an eye exam when DME is suspected, and get to know possible treatment options for the condition. 

If you have diabetic retinopathy, you are at risk for DME, which can develop only where diabetic retinopathy is present. Diabetic retinopathy occurs when diabetes is poorly controlled for a long time, because chronically high blood sugar levels can harm blood vessels in the retina, the layer in the back of the eye. The retina contains light-sensitive cells that transmit signals via the optic nerve to the brain, which processes those electrical signals into images. 

If damage to the retina’s blood vessels is severe enough, they can start to leak fluid into a part of the retina called the macula. A buildup of fluid can cause swelling (edema) in the macula, leading to distorted or lost vision, particularly in your central field of vision. 

If you have diabetes, make sure to get an annual eye exam to catch complications such as diabetic retinopathy before they become too severe. If you have already been diagnosed with diabetic retinopathy, then you should already be on a schedule of regular eye exams and treatment to prevent diabetic macular edema. 

If you or your doctor suspects you have DME, you will need a thorough eye exam to get a formal diagnosis. The tests require that your eyes are dilated with special drops. There are two main tests administered to determine the presence of DME and, if it has developed, its severity. During your exam, you may undergo one or both of the following tests. 

This test allows your doctor to assess blood flow through the blood vessels in the macula and look for areas where fluid may be leaking. To begin the test, your doctor will inject a yellow dye into your arm. The dye enters the bloodstream and eventually reaches your eyes, where it brightens the blood vessels so a special camera can take pictures that show where, if anywhere, there are leaks. 

Potential side effects include a temporary yellow tint to the skin or urine and a slight burning sensation if the dye leaked on its way to the eyes. You may notice that some objects look darker after the test. All of these side effects are temporary. If you experience a rare allergy to the dye, your healthcare team should be able to prescribe pills or injections to stop symptoms such as hives or itchy skin. 

OCT takes about 10 or 15 minutes and is performed with an OCT machine that checks the thickness of the layers in the retina. For the test, you will rest your chin in a headrest to keep your head still while the machine scans your eyes. Using light waves, the machine produces cross-section views of your retina. 

Research suggests that while FA is still the gold standard test for diabetic retinopathy and diabetic macular edema, OCT can be particularly helpful in diagnosing the conditions in late stages and for follow-up assessments to gauge the effectiveness of treatment. 

A third, simpler test does not require dilated eyes. The Amsler grid, used to check for central vision loss, looks like a large sheet of graph paper with a small dark circle in its center. As part of the exam, your doctor may ask you to look at the circle and describe what you see. If the straight lines look wavy or part of the grid looks dark, you may have DME or another eye condition, such as macular degeneration. 

If your doctor diagnoses DME, the next step is to discuss treatment options. One key is to get your diabetes under control and bring down levels of sugar in your bloodstream. Depending on the severity of your condition and your preference, you may be a candidate for anti-VEGF drugs, which are injected directly into the eye to reduce swelling. Laser treatments may be an option, especially if injections don’t bring your condition under control. A third option for DME is surgery to remove scar tissue or traction which can lead to fluid in the macula, if other treatments are unsuccessful. 

Diabetic macular edema affects about 1 in 15 people with diabetes, so it’s important to be proactive about your eye health if you have diabetes. Eye exams to check for DME may be part of your routine eye care. If not, schedule an exam soon if it has been a year or more since your last appointment. 

You should also get a DME exam if you notice symptoms such as objects looking wavy when looking straight at them. If an object appears to be different sizes when you close one eye and then the other, or if colors seem faded, schedule an eye exam and be prepared to explain these symptoms to your doctor. The earlier DME is diagnosed and treatment begins, the lower the risk of significant vision loss.