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When we deal with your eye problems, you can expect to be treated with the same degree of care and commitment as if you were a member of our family.
A macular hole is a small hole or tear in the macula (the central retina responsible for sharp central detailed vision used for reading, driving and recognising faces.) Macular holes are associated with ageing and generally occur in patients over 60 years of age. As the vitreous gel shrinks and pulls away from the macula as we age, it can stick to the macula in some people. This stretches the macular tissue (vitreomacular traction) and can result in the macula tearing forming a hole. Trauma to the eye can also cause a macular hole. There is about a 10% risk of the second eye developing the same problem in time. Most macular holes will slowly enlarge if left untreated, leaving a large dark spot (blind spot) in the central vision.
Macular hole symptoms may be subtle initially (awareness of a letter missing when reading a line of print) but progress to a blind spot in the central vision.
The symptoms include:
A macular hole is usually diagnosed with a dilated eye examination, and optical coherence tomography (OCT). OCT can diagnose small macular holes that may be difficult to diagnose in an examination.
Occasionally a macular hole will heal itself, but generally surgery is required to treat the problem. Vitrectomy surgery is performed to remove the gel that is tugging on the macula. The eye is then filled with a special gas to help flatten the macular hole and hold the retinal tissue in place while it heals. Face-down positioning is required for several days to keep the bubble in contact with the macula to allow healing. The bubble slowly dissolves and the eye replaces this with fluid. It is important to note that while a gas bubble is present you cannot fly in an airplane or have an anaesthetic using nitrous gas (these can cause a dangerous rise in eye pressure).
Eye drops are usually required for six weeks after surgery.
The visual improvement obtained after macular hole surgery depends on the size of the hole and how long it was present before surgery. The macula will slowly heal but is generally not at its best for 12months following surgery. Vitrectomy surgery can result in a cataract developing faster than its fellow eye. Macular Hole Surgery is usually successful in macular hole closure, stabilising and improving vision.
When we deal with your eye problems, you can expect to be treated with the same degree of care and commitment as if you were a member of our family.