How is Diabetic Macular Oedema Treated?

Treatment aims to reduce swelling in the macula and preserve vision. 

Treatment options may include:

• Intravitreal injections (most common treatment): Medications injected into the eye to reduce swelling and prevent further vision loss.

• Laser therapy for select cases: Laser treatment may be used to seal leaking blood vessels and reduce swelling in the macula.

 

​

Can Diabetic Macular Oedema be Prevented?

While Diabetic Macular Oedema cannot always be prevented, managing your diabetes effectively can help reduce the risk of it happening. This includes:

• Monitoring blood sugar levels regularly and keeping them within the target range recommended by your GP or endocrinologist

• Engaging in regular physical activity.

• Attending regular eye exams to detect any changes in your vision early.

 

​

Tell me more about the eye injections. 

In order to dry up the macula, a medication class called anti-VEGF, needs to be injected into the eye. Currently, three different drugs have been shown to be effective – aflibercept (Eylea), ranibizumab (Lucentis) and faricimab (Vabysmo). These medications work by inactivating molecules that cause abnormal growth of blood vessels in your eye.  

 

There is also another class of medications – a dissolvable steroid implant (Ozurdex) that can be used for diabetic macular oedema. It also is a very effective medication in the right subset of patients. 

 

 

Can you give a description of the injection procedure?

Injecting medicine into the eyeball sounds scary, but rest assured it is a short, painless procedure and over before you know it. This is usually done in my procedure room, with the steps as follows

• You are asked to lie down on the treatment bed where local anaesthetic drops are instilled into your eye to numb it 

• This is followed by a local anaesthetic injection (which is painless), to numb it further 

• Once the eye is completely numb, your eye is then sterilised with antiseptic 

• I get my patients to look down towards their nose, and within 2 seconds the injection is done, with most patients not even realising it’s over! 

• The eye is then washed with some sterile saline solution 

• No pad or eye shield is required after 

 

​

What happens after the injection? 

• You can go home directly after, but it is important to have someone drive you home 

• Patients are advised to obsessive about keeping the eye clean for the next 2 days. This means 

  • Avoiding any dusty or dirty places where there is potential for debris to get into the eye

  • Avoid any non-sterile water getting into the eye for 2 days. Showering is fine but do not get any water into the eye.

  • Avoid rubbing your eye   

  • No swimming for 1 week  

 

​

How often will I need injections? Is one injection enough?  

• Unfortunately, diabetic macular oedema requires a course of at least 3 injections to maintain or to improve your eyesight. 

• The frequency of injections will vary depending on how well your eye responds to the injections. If your eye responds favourably, we will be able to increase the intervals between injections gradually – from every 4 weeks initially up to every 4 months (that means only 4 injections per year).  

• If your eye remains well at 4 months, we can then have a discussion about considering a trial of no injections

• A typical injection schedule looks like this