This is usually addressed after recovery with the guidance of an optometrist to update any spectacle correction. Vitrectomy surgery can alter the focus of the operated eye. In the unlikely event that the macular hole remains open, further surgery can be considered. What if the surgery does not repair the hole? Eyesight typically improves progressively over a period of months and can continue to improve even up to a year after surgery. The outcome can be particularly favourable when surgery is performed sooner rather than later. Surgery improves sight in 15 of 20 people and protects sight from getting worse in 4 of 20 people. Some persistent disturbance of sight must be expected but 75% of people benefit with gradual improvement of sight. Surgery offers a 90% likelihood of repairing the hole and protecting sight. What are the likely benefits of surgery for macular hole? Macular holes do not typically affect peripheral eyesight (what you can see from the side while looking directly forward), which is normally preserved. Up to 1 in 10 small macular holes heal naturally but most macular holes cause progressively severe impairment of central sight. What is the natural outcome of macular hole? Some people may become aware of impaired eyesight only when their unaffected healthy eye is covered, or when the condition is identified by an optometrist or healthcare professional. Many people with macular hole experience distortion, blurring or a blind spot affecting the sight of the affected eye. Partial-thickness macular holes are less common and generally cause less harm to sight. Macular holes typically involve the full-thickness of the retina. A macular hole can also be caused by high myopia, physical trauma or inflammation in the eye. This process of separation, also called ‘posterior vitreous detachment’ (PVD), is usually harmless but can occasionally cause a hole in the macula. Usually, only one eye is affected but a minority of people with the condition, about 1 in 6, can have their second eye affected.Ī macular hole typically develops when normal ageing causes changes to the vitreous gel, causing it to separate from the retina. It typically affects older people and generally, it affects women more than men. Even a tiny hole in the macula can impair eyesight.Ī macular hole affects approximately 1 in 500 people. Its central spot, the ‘macula’, is particularly sensitive and is responsible for the sight needed to read, recognise faces and drive safely. The retina is the sheet of light-sensitive nerves in the eye, like the film in a camera. Professor James Bainbridge, an internationally renowned ophthalmologist, provides you with a comprehensive overview of the condition, causes, symptoms, surgery (its main form of treatment), post-surgery care and the expected results.Ī macular hole is a small hole in the centre of the retina. Without successful surgery, most people lose the ability to read in the affected eye and are "legally blind" because of poor central vision.A macular hole affects 1 in 500 people and can cause distorted vision and blind spots. Fortunately, we can help you rent a chair and other equipment to assist with staying on your stomach, face down. After the surgery, face down positioning is required for a week. The jelly is replaced with a temporary gas bubble that that disappears over a few weeks. Small instruments are inserted through the white part of the eye and used to remove the jelly and relieve the traction. If a full hole develops, a surgical procedure called a vitrectomy is required to repair the macular hole. In some cases of vitreous traction, the jelly will separate and release from the retina, leading to spontaneous recovery. Those who have had a macular hole for less than 6 months have better chance of repair than those who have had the condition longer. Approximately 10-15% of people who develop a macular hole in one eye will develop one in the other as well. This makes reading and driving difficult and usually causes severe vision loss. Typically, people will notice a central blurry spot that progresses to form a "missing area" right in the center part of vision. While the majority of macular holes just happen on their own, severe eye trauma and other pathologic eye conditions may be related. If it does not separate cleanly, it can pull at the retina and cause traction or even a hole to develop in the very center of vision. With time, it liquefies and separates from the retina, usually occurring at age 50-60. The clear vitreous jelly fills the eye cavity and is attached to the retina from birth. Macular Holes are thought to occur from tangential traction exerted on the retina. If the retina develops a complete hole, a black "missing" spot is seen everywhere the eye looks. The macula is the central part of the retina that is responsible for the detailed, clear vision necessary when reading or driving.
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