Clear central vision is for reading, recognizing faces, driving, and seeing fine details. When fluid builds up in the macula which is the central part of the retina these everyday tasks may be affected. This condition is known as macular edema.
People which present with macular edema may see blurred, distorted or wavy central vision. Some patients report that they feel like there is fluid in eyeball which isn’t quite true, what we see is fluid which has leaked into the retinal tissue. Early evaluation is important because of the risk that persistent retina swelling will affect central vision. We can better understand macular edema symptoms, macular edema causes, and available macular edema treatment which in turn will help patients to seek out appropriate eye care without delay.
What Is Macular Edema?
Macular edema results from leakage of fluid out of broken or abnormal retinal blood vessels which in turn accumulates in the macula. The macula is at the center of the retina and is responsible for detailed central vision. The build up of fluid causes that area to become thicker and swollen.
The term also goes by macular oedema in some areas. Also you may see retinal edema and retina swelling reported in the case of like conditions. But an ophthalmologist will have to determine the exact location and cause of the swelling.
In diabetics doctors may point out diabetic macular edema. The term clinically significant macular edema which is old school refers to diabetic retinal swelling that reaches certain clinical thresholds as per its location and size.
What Are the Symptoms of Macular Edema?
Macular edema symptoms present slowly and in the early stages of mild disease may go unnoticed. Blurry central vision is the most common report. What you may see as straight will instead appear bent or wavy, colors may appear faded, and fine details won’t stand out as they used to.
Some report issues with small print and face recognition. Vision also may present differently between the two eyes. In the case of macular edema which is in only one eye the other (stronger) eye may compensate which in turn may delay the diagnosis.
| Vision Change | What a Patient May Notice |
| Blurred central vision | Words or faces appear unclear |
| Distorted vision | Straight lines look bent or wavy |
| Reduced colour clarity | Colours appear dull or faded |
| Difficulty with details | Reading and close work become harder |
| Central visual changes | Objects may appear different in size |
What Causes Macular Edema?
Several diseases of the eye and the system may cause macular edema. Diabetes is a very large factor in this as diabetic retinopathy does damage to small retinal blood vessels which in turn cause them to leak. Retinal vein occlusion also does a number on normal blood flow and produces retinal edema.
Other macular edema causes include uveitis, wet age related macular degeneration, certain inherited retinal diseases, and issues post eye surgery. In some patients certain medicines may also play a role.
The issue at hand is that macular edema treatment must attend to both the swelling and the cause. Thus it is wrong for patients to think that any case of fluid in eyeball is the same.
How Is Macular Edema Diagnosed?
An ophthalmologist at first will do a comprehensive dilated eye exam. This allows the doctor to look at the retina and macula for swelling, leakage, or other issues.
Optical coherence tomography, also known as OCT, produces in depth cross sectional images of the retina swelling. It also helps to measure retina swelling and to monitor changes during treatment. A fluorescein angiogram also may help to identify leaking or abnormal retinal blood vessels.
Doctors may use retinal photos to document macular edema fundus. Also these images may be used to track retinal changes over time and to provide more info related to the base disease.
| Test | Purpose |
| Dilated eye examination | Examines the retina and macula |
| OCT scan | Measures retinal thickness and fluid |
| Fluorescein angiography | Identifies leaking retinal blood vessels |
| Fundus photography | Documents visible retinal changes |
How Is Macular Edema Treated?
The appropriate macular edema treatment is based on its cause, severity, and degree of vision impact. Anti-VEGF injections are used in conditions like diabetic macular edema and retinal vein occlusion for which they will reduce abnormally growing blood vessels. Steroid therapy may benefit some patients in which the edema is a result of inflammation.
Doctors may at times use laser treatment. In some cases of postoperative macular edema we may give anti-inflammatory eye drops. Vitrectomy may be a solution when traction or any structural issues are a cause of persistent swelling.
There isn’t a one size fits all retinal swelling treatment. An ophthalmologist will choose the appropriate treatment after performing a retina exam and determining the base issue. Follow up OCT scans will show if macular edema is improving.
Can Macular Edema Cause Permanent Vision Loss?
Untreated or chronic macular edema can cause damage to central vision in some patients. The results which the patient will have may vary according to the cause, the degree of severity, the time it has been going on and the response to treatment. An early diagnosis gives the ophthalmologist the chance to control retina swelling and to protect useful vision.
Conclusion
Macular edema affects the sharp central vision which is used for reading, driving, and recognizing faces. Diabetes, retinal edema vein blockage, inflammation, wet AMD, surgery, and other diseases can cause retinal edema. As the macular edema causes are many, accurate diagnosis is key before treatment.
If there is development of blurred or distorted central vision an eye exam may determine the cause. At ASG Eye Care, our ophthalmologists are able to study retinal changes with use of proper diagnostic tools and we will put together a retinal swelling treatment plan according to your health. Timely assessment and routine follow up care is key in the management of macular edema and in protecting vision.
Frequently Asked Questions
1. Is macular edema the same as fluid in the eye?
Macular edema is a condition which reports fluid build up and swelling in the macula. Patients may report it as fluid in eyeball, but that is a symptom of many different eye conditions which cause related fluid changes.
2. What are the early macular edema symptoms?
Common macular edema symptoms include blurred central vision, wavy or distorted lines, faded colors, and trouble with fine details. Some people may not notice anything out of the ordinary at first.
3. Is macular edema treatable?
Yes. Several options for macular edema treatment are present. Treatment may consist of anti-VEGF injections, corticosteroids, anti-inflammatory drops, laser therapy, or surgery which will depend on the base cause.
4. What does macular edema look like on a fundus examination?
The retina in cases of macular edema fundus may present with thickening of the retinal tissue, vascular anomalies, or deposits which are a result of leakage. OCT gives a more in depth analysis of the fluid content and retinal thickness.
5. Is clinically significant macular edema related to diabetes?
Yes. Clinically significant macular edema to classify certain patterns of diabetic macular swelling from what we saw in the eye during the exam.
