Macular Hole

A macular hole develops from the gradual shrinkage of the vitreous, which pulls on the surface of the retina surrounding the macula - the special part of the retina that gives us our clearest and sharpest central vision.

This shrinkage causes a small hole to develop in the macula.  You cannot have good vision if there is a hole in this area.  There is nothing that you did that causes this to happen and you could not prevent it from happening.  A macular hole will not cause total blindness.

We now have treatments available to close these holes.  There is a surgery to remove the vitreous jelly from within your eye and replace it with a gas bubble.  The bubble is then gradually replaced with the eye’s natural fluid.  This surgery is successful in closing the macular hole in greater than 90% of patients. There is also a medication that can be injected into the eye to close the hole in select patients.  The injection is performed in the office.

The surgery is performed in the operating room as an outpatient under local anesthesia.  The eye is patched for the first day and removed the following day.  We will call you at home the following morning to see how you are doing.  It is important that you maintain a facedown position at all times for the first 48-72 hours.  We even asked that you sleep in a sitting position with your face down for the first three days.   There is usually little or no discomfort related to the surgery but your back or neck may become stiff and sore due to the facedown positioning.

It will take several weeks for the gas bubble to be replaced by the natural eye fluid.  During this time your vision will be decreased.  As the bubble is replaced, your vision will gradually improve.  You can resume your normal activities in about 3-4 weeks, but you may not fly in a plane until the bubble is completely gone. Your vision may continue to improve for 6-8 months.  If you have not already had cataract surgery, you will develop a cataract over the next 12-24 months, which will eventually need to be removed by a cataract surgeon.

Patient Education