Eye Swelling at the Macula: Signs, Causes, and Remedies
Cystoid Macular Edema (CME) is a common eye condition that affects the macula, the part of the eye responsible for sharp and detailed vision. This condition occurs when fluid builds up in the macula, causing blurred or distorted vision, where images appear wavy or blurry, and colours may appear faded.
CME can be caused by various factors, including diabetes, a condition that causes high blood glucose levels, and cataract surgery. When Age-Related Macular Degeneration (AMD), a condition associated with aging, affects the macula, it can also lead to CME.
Diabetes, due to full body inflammation, decreased blood flow to the eye, and disruption of the blood-retinal barrier, can cause CME. Similarly, cataract surgery can lead to CME as a risk, especially during the recovery period.
For those experiencing vision impairments, prompt action is crucial. It is advised to make an appointment with an ophthalmologist immediately to start treatment quickly. The good news is that, with appropriate treatment, people with CME who get treatment generally regain their original vision, although it can take several months for the condition to disappear.
The diagnosis of CME involves dilating the pupils to examine the retina, followed by additional tests like optical coherence tomography or fluorescein angiography.
Common treatment options for CME caused by cataract surgery include the use of topical non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, either topical or via periocular/intravitreal injection. NSAIDs such as nepafenac, ketorolac, or bromfenac are often started before surgery and continued for weeks afterward to reduce inflammation and prevent or treat CME. Topical corticosteroids are frequently combined with NSAIDs for better control. If topical treatment is insufficient, periocular or intravitreal corticosteroid injections may be used.
In cases of CME caused by retinal vascular diseases, treatments may vary depending on the underlying cause, and can include injections of anti-VEGF drugs, steroid treatment, eye drops, laser treatment, vitrectomy surgery, or a combination of these.
Close monitoring with optical coherence tomography (OCT) is essential to monitor the progression of CME and the effectiveness of the treatment. In patients with uveitis or pre-existing inflammation, corticosteroids combined with NSAIDs are commonly used perioperatively to control inflammation and edema. Additionally, in specific infections like herpetic uveitis, antiviral treatment should be maintained to prevent recurrence.
In summary, treatment generally involves:
- Topical NSAIDs starting before surgery and continuing for 6-8 weeks postoperatively.
- Topical corticosteroids concurrently.
- Periocular or intravitreal corticosteroids for resistant cases.
- Close monitoring with OCT.
- Added antiviral therapy if infectious uveitis is present.
Remember, while CME is not a life-threatening condition, it can affect a person's quality of life and make it more risky to engage in certain activities that rely on good vision. Therefore, prompt treatment and regular check-ups with an ophthalmologist are essential to manage this condition effectively.
[1] JAMA Ophthalmology [2] American Academy of Ophthalmology [3] Retina Today
- Chronic diseases like diabetes and Age-Related Macular Degeneration (AMD) can lead to a condition called Cystoid Macular Edema (CME), which is responsible for blurred or distorted vision, often associated with eye health and chronic diseases.
- When diagnosed with CME, people are advised to seek medical attention promptly as treatment can help regain original vision, despite being a chronic medical-condition related to health and wellness.
- Current treatment options for CME include the use of topical non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, close monitoring through optical coherence tomography (OCT), and additional therapies for cases caused by retinal vascular diseases, all of which can be found in resources like JAMA Ophthalmology, American Academy of Ophthalmology, and Retina Today.
