Macular Holes

Macular holes causes

The cause of macular holes is not well understood, but the risk of developing a macular hole is increased for:

• 

  Persons who have had blunt eye trauma
• Diabetics
• People with a condition where the gel inside their eye pulls away from the retina (known as vitreomacular traction).
• Folks who already have a macular hole in one eye as they have a 15 percent chance of developing a macular hole in their other eye

Macular hole symptoms 

Actually, it's not so easy to know whether you have a macular hole because they are painless. The most common symptom of a macular hole is a gradual decline in central vision. This can take the form of blurred vision, distorted vision (where straight lines will appear wavy), or a growing dark spot in the central visual field.

The diagnosis of a macular hole requires a dilated eye exam with close inspection of the retina plus an imaging test called an OCT (ocular coherence tomography) that uses light waves to take cross-sectional pictures of the retina.

Macular hole treatment

Treatment of a macular hole requires a surgery called a vitrectomy. In this surgery, tiny instruments are used to remove the gel which fills the inside of the eye. This helps to relieve any traction caused by the gel pulling away from the retinal surface that tugs on the macula.

Once the gel is removed, the eye is filled with a special gas bubble which helps to flatten the edges of the macular hole against the eyewall to allow it to grow back together.

What's unique about macular hole surgery?

The surgery to repair a macular hole is unique because a gas bubble placed in the eye must remain in contact with the macula following surgery in order for the macular hole to remain pressed against the eyewall.

In order for this to happen, the patient must lie face down and remain in this position for 5 to 7 days following surgery. This is necessary because gas rises and THE ONLY way to keep the bubble in contact with the macula is to keep the head in a face-down position. This is extremely important to the success of the surgery since, without proper positioning, the hole has a poor chance of healing.

The gas bubble will slowly dissolve on its own over a month or so. While any gas is present in the eye it is CRITICAL to avoid any airplane or altitude travel until cleared to do so by the surgeon. This is because gas expands at altitude and this can cause an extreme elevation in eye pressure which can lead to irreversible vision loss.

As the macular hole closes, the eye slowly regains part of the lost vision. The extent of visual recovery depends on the size of the hole and how long it was present before surgery. Unfortunately, once a macular hole forms, vision may not return all the way to normal.

Experience Assil Gaur Eye Institute's nationally recognized expertise in treating macular holes

The AGEI staff includes a highly skilled retina specialist Dr. Svetlana Pilyugina or “Dr. P”, as she is known to her patients. Dr. P is a Stanford-educated and fellowship-trained ophthalmologist. She is board certified in diseases and surgery of the vitreous and retina.

Dr. Pilyugina has extensive experience in the treatment of macular hols and all retinal conditions. To schedule an appointment, either call 866-945-2745 or click here to make an appointment online.