If you've recently had cataract surgery and you also suffer from diabetes, you need to keep a close eye on your ocular health in the following months and years. This is because cataract surgery comes with a unique risk for people with diabetes—one which can be serious if left untreated. Here's all you need to know.
What's the Risk?
Like any surgery, cataract removal comes with its own risks, including infection and glaucoma. However, for people with diabetes, there's an even more worrying risk attached to cataract surgery: diabetic macular oedema. Diabetic macular oedema occurs when blood vessels leak fluid into your macula (the part of your eye that controls detailed vision) as a result of a diabetes complication called diabetic retinopathy. If left untreated, diabetic macular oedema can cause irreversible blindness; in fact, it's one of the leading causes of blindness in working-age Australians.
While anyone with diabetes can develop the condition, studies have shown that there's an increased risk for those who have undergone cataract surgery in recent years. This is because eye surgeries can cause inflammation as well as the formation of new blood vessels, both of which can accelerate the progress of pre-existing, undetected, early-stage retinopathy.
To avoid developing diabetic macular oedema, it's important that you remain vigilant after your cataract surgery and keep an eye on your ocular health.
How Can You Know if You Have It?
The most common symptom of diabetic macular oedema is blurry or wavy vision in and around the centre of your field of vision. Alongside that, those with the condition may experience vision loss or see in colours that look faded. However, since these symptoms can be mild and gradual at first (and may only occur in one eye), many people don't notice them until the macular oedema is in its advanced stages.
As a result, the only way you can know you have diabetic macular oedema is to get tested by an eye doctor. They can use a variety of tests to determine whether you have macular oedema and what stage it's in if you do have it. Some common diagnostic tests include a typical 'eye test' (where you read letters off a chart), an examination of your retina using dilating eye drops, or a fluorescein angiogram where a special dye is injected into your arm and then tracked as it moves through the blood vessels in your eyes.
Since it's hard to judge your risk by symptoms alone, you should see your eye doctor for these tests on a regular basis after cataract surgery, even if your vision is fine. However, if you do feel your vision worsening, don't wait until your next scheduled appointment—the earlier you catch the condition, the better.
What Can You Do to Treat It?
Thankfully, if caught early enough, diabetic macular oedema is treatable. There are multiple treatment options available, and the ones you're offered will depend on which eye doctor you choose, how advanced your condition is, other underlying health concerns and your own preferences. These treatments will improve any vision loss you have and reduce your risk of permanent blindness.
One of the most common treatments is anti-VEGF injections. VEGF is a protein your body overproduces when you have diabetic macular oedema, causing fast blood vessel growth and fluid leakage. The anti-VEGF injections reduce your levels of this protein. A course of VEGF usually starts with one injection a month for 6 months, then gradually decreases over the following years. During a treatment, your doctor will numb your eye, then inject the medicine into the centre of it with a thin needle.
When anti-VEGF injections aren't right for you (for example, if you're pregnant), you may be offered a steroid implant or pellet instead. These options slowly release medication into your eye over several months or years. Other treatments include anti-inflammatory eye drops for those with pre-macular oedema or laser surgery to seal leaking blood vessels in your eyes.