Macular Holecauses, symptoms and treatments

Text size:
Last updated 6/4/2021
Dr. Svetlana Pilyugina talks about macular holes

What's a Macular Hole?

The macula is responsible for distinguishing fine details, perceive facial features, read printed material, or focus on distant objects in order to drive, for example.

 

A macular hole is a small full-thickness break in the lining at the very center of the macula. Macular holes are not uncommon.

 

They occur more frequently after 55 years of age and women are somewhat more affected than men.

Macular holes causes

 

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

  • What's a Mcular Hole?
    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 Eye Institute's nationally recognized expertise in treating macular holes

The AEI 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.

1945 Total 1st Party Reviews
4.9 out of 5 Stars
  • Google
    I was referred to Assil Eye institute by my sister and two nieces. I got my first appointment fairly quickly. All of the employ...
    Masoud D.
  • GatherUp
    I am very pleased.
    Aida Y.
  • GatherUp
    Dr. Assil is a skilled and innovative surgeon who is also a compassion and warm person. Personally, I think he is a genius who ...
    Stephanie B.
  • GatherUp
    Excellent and hospitable staff!
    Dimitri S.
  • GatherUp
    You and your team are the best ... unequaled in the business.
    Reta M.
  • Google
    Great surgeon Dr Assil is a wonderful person and a Genius doctor.
    Vince W.
  • GatherUp
    Staff and Dr Gaur are great.
    Jeffrey S.
  • GatherUp
    I appreciate the kindness of everyone I met.
    Roger C.
  • GatherUp
    Only place/ doctors i would go for eye issues/ surgeries!
    Janna R.
  • Google
    It was as a pleasure going to his office. His staff is efficient, pleasant and answered all my questions. I would highly reco...
    Vickie M.
  • GatherUp
    Total pros entire staff
    Anthony I.
  • GatherUp
    Thank you so much for everything very happy
    Everyone is super nice
    Amad S.
Look Who Trusts Their Eyes to Assil Eye Institute...
  • LeBron James

    Los Angeles Lakers

    LeBron James is one of the NBA's greatest of all time. He absolutely depends on his vision to perform at the very highest level. That's why he's an AEI LASIK surgery patient.

  • Anthony Davis

    Los Angeles Lakers
  • Chris Paul

    Phoenix Suns
  • Paul George

    Los Angeles Clippers
  • Marlee Matlin

    Actress
  • Michelle Williams

    Actress
  • Dwyane Wade

    Miami Heat (retired)
  • LaToya Jackson

    Entertainer
  • Lorenzo Lamas

    Actor
  • Philip Bailey

    Earth Wind and Fire
  • Gary Sinise

    Actor
  • Rip Hamilton

    Former NBA player
  • John Salley

    Commentator, former NBA player
  • Blair Underwood

    Actor
  • Tom Arnold
    Comedian/Actor
  • Troy Evans
    Actor
  • John Noble
    Actor
  • Isaac Eddy
    Actor/Director/Teacher
  • Barbara Rush
    Actress
  • John Emerson
    US Ambassador to Germany
  • Shane Mosley
    Former professional boxer
  • Cuttino Mobley
    Former NBA player
  • Seth Gordon
    Director
  • Maurice Evans
    Former NBA player
  • Wang Luoyong
    Actor
  • Jesse Metcalfe
    Actor
  • Ananda Lewis
    Television Personality
  • Rob Brydon
    Comedian
  • Clifton Collins Jr.
    Actor
  • Malinda Williams
    Actress
  • Adrienne Frantz
    Actress
  • Lacey Chabert
    Actress
  • Brad Pitt
    Actor
  • LeBron James
    Los Angeles Lakers
  • Anthony Davis
    Los Angeles Lakers
  • Chris Paul
    Phoenix Suns
  • Courtney Cox
    Actress
  • Paul George
    Los Angeles Clippers
  • Marlee Matlin
    Actress
  • Michelle Williams
    Actress
  • Dwyane Wade
    Miami Heat (retired)
  • Jalen Brunson
    Dallas Mavericks
  • Mychal Thompson
    Commentator, former NBA player
  • LaToya Jackson
    Entertainer
  • Lorenzo Lamas
    Actor
  • Philip Bailey
    Earth Wind and Fire
  • Gary Sinise
    Actor
  • Rip Hamilton
    Former NBA player
  • John Salley
    Commentator, former NBA player
  • Blair Underwood
    Actor
  • Tom Arnold
    Comedian/Actor
  • Troy Evans
    Actor
  • John Noble
    Actor
  • Isaac Eddy
    Actor/Director/Teacher
  • Barbara Rush
    Actress
  • Rudy Garciduenas
    Blue Man Group
  • John Emerson
    US Ambassador to Germany
  • Shane Mosley
    Former professional boxer
  • Cuttino Mobley
    Former NBA player
  • Seth Gordon
    Director
  • Maurice Evans
    Former NBA player
  • Cheri Blauwet
    Physician and Wheelchair Racer
  • Wang Luoyong
    Actor
  • Jesse Metcalfe
    Actor
  • Jeana Wilson
    Actress
  • Courtnee Draper
    Actress
  • Ananda Lewis
    Television Personality
  • Robyn Johnson
    Producer
  • Rob Brydon
    Comedian
  • Cary Schuman
    Actor
  • Roland Buddy Lewis Jr.
    Comedian
  • Clifton Collins Jr.
    Actor
  • Malinda Williams
    Actress
  • Chad Jeffers
    Musician
  • Adrienne Frantz
    Actress
  • Franco Carlotto
    Body Builder
  • Brad Mates
    Musician
  • David Pichette
    Musician
  • Mike Melacon
    Professional Baseball Player
  • Nautica de la Cruz
    Radio Personality
  • Lynn Conkwright
    Body Builder
  • Nely Galan
    Producer
  • Roxanne Galla
    Actress
  • Lacey Chabert
    Actress