Adeel Shaikh

Macular Hole

The retina is a thin layer of nerve tissue that lines in inside of the eye. Retina has a function is to capture light and send visual data to the brain. The macula is the region of the retina that is the center focusing point of the retina.

A macular hole is a hole in the macula. Most macular holes are brought about by abnormal pulling of the vitreous gel that typically fills the back of the eye. This pulling may cause the vision to decline. If a full thickness hole develops then patients may notice a sharp decline in vision and focus.

Most macular holes happen without any underlying reason. These are called idiopathic macular holes.  Other reasons may include large persistent macular edema and injury.

Diagnosis

Exam with a retina specialist will determine the stage of the macular hole. The retina specialists can do an optical coherence tomography (OCT) testing to evaluate the size and stage of the macular hole in more detail.

Treatment

Vitrectomy surgical procedure is commonly performed to close macular holes. The objective of the procedure is to remove the gel and membranes that are pulling on the macula. The eye is then filled with gas bubble. Following the procedure, the patient positions his/her head face down for the initial 3-7 postoperative days. This allows the gas to push against the hole which helps the hole to close. The gas bubble dissolves on its own in a few weeks.

Prognosis

Visual improvement following macular hole surgically procedure happens steadily as the eye heals. Approximately 90% of the macular holes can be closed with a single surgical procedure. Many patients will keep on showing steady visual improvement as long as 2 years following the procedure.