What is a Macular Hole?

A macular hole is a condition that affects the center of the retina, known as the macula, causing a small break or hole in the tissue. As the hole forms, things in your central vision will look blurry, wavy or distorted. As the hole grows, a dark or blind spot appears in your central vision. A macular hole does not affect your peripheral (side) vision. 

Causes of Macular Hole

• Typically develops due to aging processes.
• Can also result from trauma 
• A very high degree of  myopia (nearsightedness).
• Inflammation inside your eye (Uveitis) 

Risk Factors

• Advanced age
• Trauma to the eye 
• Severe myopia.
• Eye conditions like diabetic retinopathy.
• History of retinal tear/detachment 
• Diabetes 

Symptoms

• Blurred vision 
• Distorted vision.
• Difficulty reading or performing tasks that require detailed vision.
• Straight lines appear wavy or distorted.

A later sign of a macular hole is a dark or blind spot in the center of your vision.

Diagnosis

• Diagnosed through a comprehensive eye exam, including OCT (optical coherence tomography), Fundus Photo to visualize the macula.
• Optical coherence tomography (OCT) is the current gold standard in the diagnosis, staging, and management of macular holes. This quick, non-invasive imaging technique allows for evaluation of the macula in high resolution

Are Macular Holes common?

One U.S. study indicates that the number of new cases of macular hole is 7.8 people per 100,000 people per year. It happens much more often in people ages 55 and over, but it can happen to anyone

Treatment Options

Observation

• The patient may undergo periodic eye examinations including optical coherence tomography (OCT) scans to assess any changes in the hole’s size or impact on vision.
• In cases where the macular hole is very small and does not have a large impact on your vision, your doctor may not recommend any treatment at all. He or she may simply observe and track the macular hole’s progression or natural healing. 
• In this case, it would be important to have regular follow-up eye examinations as determined by your eye doctor to catch and treat any problems early.

Vitrectomy Surgery

• During this procedure, the vitreous gel that fills the eye is removed to prevent it from pulling on the retina. After removing the vitreous, the surgeon will typically insert sterile gas into your eye to keep pressure on the hole until it heals., which helps to gently push the edges of the macular hole back into place, allowing it to heal. 
• The only consistently successful way to treat a macular hole is an operation. Eye drops or glasses are ineffective.

• Vitrectomy has a success rate of over 90%, with patients regaining some or most of their lost vision. 

Gas Bubble: 

The gas bubble acts as an internal temporary bandage that holds the edges of the macular hole in position as it heals.Patients are required to maintain a face-down position for several days. This positioning is crucial as it allows the bubble to press against the macula and helps in the sealing process. 

Recovery

Recovery from macular hole treatments, particularly after vitrectomy surgery or gas bubble injection, involves specific post-operative care. Patients must often maintain a face-down position for several days to a week to help the gas bubble effectively seal the hole.  The gas bubble lasts three to eight weeks and your vision remains blurry while the gas bubble’s in the eye. It may take several months for your vision to improve and stabilize.

What is the success rate of macular hole surgery ?

The success rate of macular hole surgery depends on many factors. Overall, there is about a 90% chance of closing the macular hole. 

However AK Institute of Ophthalmology is equipped with the best technology, techniques and expert doctors to take care of this. 

Nevertheless, there is a small chance that your vision may not improve after surgery, even if the hole is closed.