Although Salazar, now 34, from Edinburgh, Texas, was aware that eye complications were a possible side effect of uncontrolled diabetes, she initially chalked up her symptoms to her job. “I was using the overhead projector a lot, and I thought it was from that,” she says. Eventually, though, the symptoms began to worsen, and Salazar had to quit her teaching job, because she could no longer drive, read her lesson plans, or recognize faces. “When people called to me from a distance, I had no idea who they were,” she says. At the urging of her sisters, Salazar finally met with a retinal specialist in a nearby town — the same physician who treated her mother, who also has type 2 diabetes. The diagnosis: Salazar had developed a vision condition called diabetic macular edema, or DME.
Seeking Treatment for Diabetic Macular Edema
DME is an eye disease that can result in blurry central vision as well as vision distortion. The condition affects nearly 4 percent of people with diabetes aged 40 and over, according to a report published in July 2016 in American Journal of Managed Care. And some populations may be more at risk than others. According to a study published in November 2014 in the journal JAMA Ophthalmology, non-Hispanic Black Americans are also more likely to have DME than non-Hispanic white Americans. Here’s what DME looks like in the body: When a person’s blood sugar levels remain high over a long period of time, the tiny blood vessels in the back of the eye can become damaged. In people with DME, these vessels begin to leak fluid, causing swelling in the macula — an area in the center of the eye’s retina — and blurring of central vision, says the National Eye Institute (NEI). Detecting DME in its early stages can halt the damage and prevent blindness, according to the NEI. This is one reason experts recommend that people with diabetes get regular eye exams (along with taking steps to lower blood sugar levels, if needed). As for Salazar, she was legally blind in one eye and visually impaired in the other. She isn’t alone. The NEI says that DME is a cause of vision loss in people who have diabetes and may affect about 750,000 people. Having other medical conditions, including high blood pressure, may also increase the risk of blindness in people with DME. The treatments for DME include injections (anti-VEGF drugs; VEGF stands for vascular endothelial growth factor), which are the standard treatment option. They work by helping to stop fluid leaks in the eye. Other options include corticosteroids, which can reduce inflammation in the eye, and laser treatments, which close leaky blood vessels, according to the NEI. Salazar’s doctor prescribed a standard treatment of regular corticosteroid injections in each eye. These were given to her every six to eight weeks to repair the leaky blood vessels and helped restore her sight between treatments. Corticosteroids can be given as eye drops, as injections, or with an implant that doles out regular doses of the medication over time. After receiving the injections, Salazar’s specialist also recommended the implant. The device then released a continuous dose of corticosteroids over a three-year period, which helped repair the leaky blood vessels.
Managing DME Over Time
Today, Salazar’s vision is greatly improved. “I can tolerate more light now, and I can actually do more things like reading and driving,” she says. “And when people come up to me from a distance, I know who they are!” With the help of corrective lenses, Salazar’s eyesight is now 20-40 in one eye and 20-50 in the other. “The hemorrhaging and inflammation are under control, too,” she says. Though she still has some trouble performing certain daily tasks — driving, reading, watching TV — for the most part, Salazar is able to maintain a normal lifestyle with the use of injectable medications and laser treatments. Devices for people with low vision, such as e-readers and head-mounted technology, can also help people maximize their eyesight and navigate their daily tasks. “These treatments have saved my life,” she says.
