As ophthalmologists/retinal specialists, we have all cancelled everyone except for those cases that we consider "urgent". Each of us may have our own definition of what is considered urgent. Although diabetic macular edema is treated with anti-VEGF injections, it is a different disease than wet AMD. While wet AMD can progress very quickly if injections are missed or delayed, vision loss from DME is usually at a slower rate and even if treatment is delayed, any subsequent vision loss can often be regained when treatment is resumed. For that reason, many specialists are trying to delay injections in patients with DME, especially if they are elderly or have any other systemic risk factors that would put them at added risk of catching the virus. That being said, if you or your patient is concerned about missing injections or is experiencing vision loss, my advice is to contact the treating physician so that appropriate follow-up can be arranged.

A blocked nasolacrimal duct can be opened by probing but this is not being done at this time as it is an elective office procedure that is aerosol generating. Supportive measures such as artificial tears and warm compresses during the day and Lacrilube ointment at night may offer some symptomatic relief until a consultation with the specialist can be arranged.

The frequency of injections for DME varies from patient to patient. There are different treatment paradigms that have been studied and each physician has their own strategy. Injections are often started on a monthly basis and continued for at least 5 or 6 injections until the macula and visual acuity is dry and stable. At that point, treatment may be stopped to see if the DME recurs. As Diabetes is a chronic disease, the edema often recurs and at this point, further injections would be given using individual maintenance schedules to try and control the edema with as little treatment as necessary.