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The macula is a specialized area of one of the most important parts of your
eye -the retina. The retina is a thin layer of light-sensitive tissue
that lines the back of the eye. Light rays are focused onto the
retina, where they are transmitted to the brain and interpreted as the
images you see. The macula is the portion of the retina responsible
for clear, detailed vision.
How does a macular hole form?
Your eye is filled with a
jelly-like substance called vitreous gel, which lies in front of the macula.
As you age, the vitreous gel shrinks and pulls away from the macula, usually
with no negative effect on your sight. In some cases, however, the
vitreous gel adheres to the macula and is unable to pull away. As a
result, the macular tissue stretches. After several weeks or months
the macula tears, forming a hole. Less common causes of macular holes
include injury and long-term swelling of the macula.
 What
are the Symptoms of a Macular Hole?
In the early stages of hole
formation, your central vision becomes blurred and distorted. If the
hole progresses, a blind spot develops in central vision and impairs both
distance and near activities.
It is important to note that
if the macula is damaged, you will not lose your entire vision. You will
still have peripheral, or side, vision.
What Tests Will be
Performed?
Dr. Cano or Dr. Manning will
diagnose a macular hole by looking inside your eye with special instruments.
To further evaluate the condition of the macula, the doctors may take
special photographs of your eye using a procedure called fluorescein
angiography.
How is a Macular Hole
Treated?
Vitrectomy surgery is the most
effective treatment to repair a macular hole and possibly improve vision.
The surgery involves using tiny instruments to remove the vitreous gel that
is pulling on the macula. The eye is then filled with a special gas
bubble to help flatten the macular hole and hold it in place while it heals.
You must maintain a constant face-down position for one to two weeks after
surgery to keep the gas bubble in contact with the macula. A
successful result often depends on how well this position is maintained.
The bubble will then slowly dissolve on its own.
Do not fly in an airplane or travel to high altitudes until the gas
bubble has dissolved. A rapid increase in altitude can cause a
dangerous rise in eye pressure. You can expect some discomfort after
surgery. You will need to wear an eye patch for a short time.
The doctors will prescribe eyedrops for you and advise you when to resume
normal activity.
As the macular hole closes,
the eye slowly regains part of the lost sight. The visual outcome may
depend on the size of the hole and how long it was present before surgery.
Vision does not return all the way to normal.
What are the Risks of
Vitrectomy Surgery?
Some of the risks of
vitrectomy include:
- infection of the eye
- bleeding of the eye
- retinal detachment
- high pressure in the eye
- poor vision
- accelerated cataract formation
It is important that you discuss the
potential risks and benefits of this procedure with the ophthalmologist
before making a decision regarding treatment.
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