Why the macula swells
Retinal blood vessels normally have tight walls. Diabetes weakens them; a blocked vein raises pressure inside them; inflammation makes them leaky; and the mild inflammation after cataract surgery can do the same for a few weeks. Fluid escapes into the layers of the retina, and because the macula is where the cells are packed most densely, swelling there disrupts vision immediately. Over months, persistent fluid damages the photoreceptors.
Symptoms
Blurred central vision, often with distortion of straight lines, washed-out color, and difficulty reading. Onset is gradual with diabetes and vein occlusion, and typically appears a few weeks after cataract surgery in the post-surgical form. There is no pain.
Diagnosis
OCT is the definitive test. It shows the fluid as cystic spaces within the retina and thickening of the macula, measures the thickness to the micron, and tracks the response to treatment scan by scan. A dilated examination identifies the cause, and angiography by a retina specialist maps the leakage when injections or laser are being planned.
Treatment by cause
- After cataract surgery: anti-inflammatory drops, both steroid and non-steroidal, for several weeks resolve most cases; injections, by a retina specialist, for the few that persist
- Diabetic macular edema: anti-VEGF injections are the main treatment, with laser or steroid implants for some patients; control of blood sugar and blood pressure alongside
- Retinal vein occlusion: anti-VEGF injections, sometimes steroid implants
- Inflammatory (uveitic) edema: treatment of the inflammation, with steroid drops, injections or systemic medication
We diagnose macular edema, treat the post-surgical form, and refer the other forms to retina specialists for injections, co-managing your care with them.
Preventing it after cataract surgery
Patients at higher risk (those with diabetes, previous vein occlusion, uveitis or an epiretinal membrane) are identified at the cataract evaluation, their macula is imaged beforehand, and they receive intensified anti-inflammatory drops around surgery. This keeps post-surgical edema uncommon and, when it occurs, mild.
Is this right for your eyes?
Nothing on this page is a diagnosis. Whether this is what is affecting your vision is decided by a full examination at one of our 4 offices: Pasadena, Huntington Beach, Woodland Hills and Beverly Hills.
About this content: This page was written with the assistance of AI tools and reviewed for medical accuracy by Dr. Bavand Youssefzadeh, DO. It is general information, not medical advice, and does not replace an eye examination. Individual results vary. Read our medical disclaimer.
