Can You Dive with Macular Edema? Expert Insights on Safety - Ophthalmology

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Can a person with macular edema engage in scuba diving?


Hello doctor, I have had macular edema for about 5-6 years, with recurrences 2-3 times a year.
Each time, I have undergone fundus photography and OCT, and I have been taking the medication Eylea until the edema resolves.
It recurred again last week, and the OCT results showed a central thickness of 306 micrometers.
The doctor mentioned that there are currently no medical reports indicating whether scuba diving affects macular edema.
I would like to ask if it is safe to go scuba diving while the edema has not yet resolved, at a depth of less than 30 meters.
Thank you.

Anita, 30~39 year old female. Ask Date: 2021/03/27

Dr. He Jianxian reply Ophthalmology


In theory, there should be no contraindications, but if you have psychological concerns, it is also not advisable to pause diving until symptoms improve.
Dr.
He Jianxian, Department of Ophthalmology, Nantou Hospital.

Reply Date: 2021/03/27

More Info


When considering diving with macular edema, it is essential to understand the potential risks and implications for your eye health. Macular edema, characterized by the accumulation of fluid in the macula, can lead to vision impairment and is often associated with conditions like diabetic retinopathy or retinal vein occlusion. Given your history of recurrent episodes and ongoing treatment, it is crucial to approach diving with caution.


Safety Considerations for Diving with Macular Edema
1. Pressure Changes Underwater: Diving involves exposure to increased pressure, which can affect the eyes. Although there is no definitive medical literature indicating that diving directly exacerbates macular edema, the pressure changes could potentially influence fluid dynamics in the eye. This is particularly relevant for individuals with pre-existing ocular conditions.

2. Vision Impairment: Macular edema can lead to blurred or distorted vision. If your vision is significantly affected, diving may pose additional risks, such as difficulty in navigating underwater or responding to emergencies. It is vital to assess your visual acuity before considering a dive.

3. Medical Clearance: Before engaging in any diving activities, especially with a history of macular edema, it is advisable to seek clearance from an ophthalmologist and a diving medical examiner. They can evaluate your current eye health, the severity of the edema, and any potential risks associated with diving.

4. Diving Depth and Duration: You mentioned a depth of 30 meters (approximately 98 feet). While this depth is within recreational diving limits, the duration and conditions of the dive also matter. Longer dives or those in challenging conditions may increase stress on your body and eyes.

5. Monitoring Symptoms: If you decide to dive, it is crucial to monitor your symptoms closely. If you experience any changes in vision, such as increased blurriness, flashes of light, or new floaters, you should abort the dive and seek medical attention.

6. Hydration and Health: Staying well-hydrated is essential for overall health and can help manage macular edema. Dehydration can exacerbate fluid retention issues, so ensure you are adequately hydrated before and after diving.


Conclusion
While there is no explicit contraindication for diving with macular edema, the decision should be made cautiously and in consultation with your healthcare providers. Your ophthalmologist can provide personalized advice based on the current state of your macular edema and overall eye health. If you are cleared to dive, ensure you take all necessary precautions, monitor your vision closely, and be prepared to abort the dive if any concerning symptoms arise.

Ultimately, your safety and eye health should be the top priority. If you have any doubts or concerns, it is always best to err on the side of caution and postpone diving until your condition stabilizes.

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