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Your ophthalmologist has diagnosed
a macular hole in your eye.
This condition occurs
when there is a small break in the macula,
the part of your eye responsible for your central vision.
Your ophthalmologist has recommended
repairing your macular hole with vitrectomy surgery.
This type of surgery has been shown to be effective
in improving central vision for people with macular hole.
To understand how a macular hole affects your vision,
let's take a look at how the eye works.
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Light rays enter the eye
through the cornea, pupil, and lens.
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These light rays are focused on the retina,
the light-sensitive tissue lining the back of the eye.
The retina has two areas: the peripheral retina,
which gives us our side or our wide angle vision,
and the macula, the small area at the center of the retina.
The macula gives us our pinpoint vision,
allowing us to see detail clearly.
The inner eye is filled
with a clear jelly-like substance
called vitreous.
As we age, the vitreous becomes less like jelly
and more like liquid.
Usually, the vitreous is only loosely attached to the retina,
so as the eye moves,
the vitreous moves away from the macula
without causing problems.
In some cases, however,
the vitreous sticks to the macula
and is unable to pull away.
As a result, the macula tissue stretches,
and a hole may form.
Your ophthalmologist will repair your macula
with vitrectomy surgery.
This procedure is done in an operating room.
To perform a vitrectomy,
your ophthalmologist makes tiny incisions
in the sclera, or white of the eye.
A small instrument is placed into the eye
to remove the vitreous gel.
Once the vitreous is removed,
your surgeon also may remove some membranes
on the surface of the macula.
Generally, a gas bubble is injected into the eye
to help flatten the macular hole
and hold the retinal tissue in place while it heals.
If a gas bubble was placed in your eye,
your ophthalmologist may recommend
that you keep your head in a special position
for a certain period of time during recovery
to properly keep the retina in place.
You will not be able to see well
with a gas bubble in place.
As you recover, your eye naturally makes fluid
that gradually replaces the gas bubble.
Avoid air travel with a gas bubble in the eye.
Also, if you are going to have any other surgery,
be sure to let your anesthesiologist know
before surgery
that you have a gas bubble in your eye.
If the macular hole closes successfully,
your vision may continue to improve
for as long as six months after surgery.
As with any procedure, there are risks
of side effects and complications
with vitrectomy surgery to repair a macular hole.
For instance, there is the risk
that the hole may not close after surgery.
Also, if you have not had cataract surgery,
it is likely that you will develop a cataract,
or a clouded lens, in the affected eye
requiring surgery at some point.
Other risks include bleeding,
eye infection, retinal detachment,
new or recurring scar tissue inside the eye,
clouding or scarring of the cornea,
a droopy eyelid,
increased pressure in the eye called glaucoma,
vision loss, and the possible need
for additional treatment,
including medication and surgery.
Your eye problem could remain or get worse.
You do not have to be treated for your macular hole.
However, if it is left untreated,
a macular hole will lead to permanent loss of vision.
Be sure to keep all your appointments
with your ophthalmologist after treatments.
Also, if you have any changes in your vision,
you should call your ophthalmologist right away.
Monitoring your vision is a vital step
toward the goal of preserving your sight.
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