Macular Swelling Has Good Prognosis
Picture this: You're out raking leaves on a beautiful autumn day. You are surrounded by brilliant Fall colors and clean, fresh air... life is good. However, you soon realize that you forgot your gloves! The burning pain in your thumb makes you wish that you had worn them, because now you have a blister. Fortunately it will be healed in a few days, and your daily routine will proceed without interruption.
Small blisters on our hands and feet are no more than a nuisance. But what if you had a tiny blister inside of your eye... on your central retina. How would your daily routine be affected?
Central retinal swelling is a common problem referred to as cystoid macular edema (CME). Let's analyze this obscure medical term. Cystoid means that the retina (the thin layer of tissue that lines the inside wall of the eye) has a foamy, cystic appearance. The cystic changes are in the central area of the retina, known as the Macula, the area of our most acute vision. Clear fluid fills the cystic spaces, producing the swelling or edema.
CME is one of the most common complications of intraocular surgery, including cataract surgery. The risk of developing this after cataract surgery is about three percent. That means, on average, three out of every one hundred patients having cataract surgery will develop CME. CME results from the inflammation that accompanies the surgical procedure. Fortunately, CME can have varying degrees of severity, and many patients have only mild a decrease in their vision. CME can also result from other types of ocular inflammation and conditions such as severe eye infections, trauma to the eye and diabetic eye disease.
The treatment of CME includes steroid drops, and non-steroidal medications, such as Motrin and Voltaren. Occasionally, steroid injections next to the eye or directly into the eye are necessary to reduce inflammation and relieve the swelling. In the case of CME due to diabetes, laser treatments are very useful to help resolve the edema.
The long term prognosis for patients with CME is excellent. Many patients will recover 20/40 vision or better with appropriate treatment and a little patience. Many ophthalmologists try to prevent CME by prescribing anti-inflammatory medications before any elective eye surgery. I do this for high-risk patients and have had good results. It's kind of like wearing gloves to prevent a blister.
