Macular hole
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Macular Hole
What is it?
A small (1/2 mm) hole in the most central retina.
What symptoms does it cause?
Blurring or distortion of central vision, or a central
blind spot.
Who gets a macular hole?
66% of patients are women, usually between the age of
60 and 80.
What causes a macular hole?
The clear gel inside the eye (the vitreous) exerts traction
on the central retina pulling it apart. Why and how
the vitreous does this is not completely understood.
What can be done for a macular
hole?
Surgery to remove the vitreous gel (vitrectomy)
and inject a gas bubble is successful in repairing approximately
90% of macular holes. The surgery is performed on an
outpatient basis and takes about an hour.
What happens after surgery?
Patients are asked to maintain face down position for
ten days so that the gas bubble can hold the hole closed
while it heals. The bubble slowly dissolves over approximately
6-8 weeks.
How do I remain facedown for
10 days?
This is obviously the most difficult part of the
process. We provide patients with specially designed
face-down equipment (used by massage therapists and/or
chiropractors) which is very helpful particularly during
sleep. During the day, patients may be up and around
as long as they continue to look down at the center
of the earth.
What if I don't remain face
down?
Surgery still sometimes works but the success rate drops.
Surgery without any position restriction succeeds in
approximately 50% of cases.
Is this surgery covered by
insurance?
Yes.
How much vision can be recovered
with surgery?
With successful surgery, the average patient regains
vision of approximately 20/50. 50% of patients achieve
20/40 or better vision with a small percent returning
all the way to 20/20!
What are the complications
of surgery? The most common complication is cataract formation. This occurs in almost everyone and usually requires cataract surgery within two years after macular hole surgery. Other complications are rare but include visual field loss, retinal detachment, and infection.
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