Retina

Macular Hole

Overview

The macula is the part of the retina responsible for acute central vision, the vision one uses for reading, watching television, and recognizing faces.  A macular hole is a small round opening in the macula. The hole causes a blind spot or blurred area directly in the center of your vision. Most macular holes occur in the elderly.  When the vitreous (the gel-like substance inside the eye) ages and shrinks, it can pull on the thin tissue of the macula, causing a tear that can eventually form a small hole.  Sometimes injury or long-term swelling can cause a macular hole.  No specific medical disease is known to cause macular holes

Treatment

Vitrectomy surgery is the only treatment for a macular hole. The surgeon removes the vitreous gel and scar tissue pulling on the macula and keeping the hole open. The eye is then filled with a special air bubble to push against the macula and close the hole. The air bubble will gradually dissolve, but the patient must maintain a face-down position for one to two weeks to keep the gas bubble in contact with the macula. The success of the surgery often depends on how well the position is maintained.

Vitrectomy surgery may not completely restore vision. Your vision will improve as the macular hole closes. It may take several months for the hole to finish healing. How much vision you get back depends on the size of your macular hole. It also depends on how long the hole was there before you had surgery.

Virectomy Surgery Risks

Like any surgery, vitrectomy has risks. They include:

  • Eye infection

  • Bleeding in your eye

  • A detached retina (where the retina lifts away from the back of the eye)

  • Glaucoma, when pressure increases inside the eye

  • Developing a cataract, which is when the lens in your eye becomes cloudy

 

Your ophthalmologist will discuss about these risks and how vitrectomy surgery may help you.

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