Although an eyeball is rather small in size, the amount of details contained within are numerous and intricate. One of the most important aspects of the eye is the ‘retina.’ The retina is composed of light-sensitive tissue at the back of the eye. Light filters through the retina where it is transported to the brain and translated into the images we see. Located at the center of the retina is the ‘macula’ which provides us with sharp and detailed vision.
The round shape of an eye is due in part to a gel-like substance known as ‘vitreous.’ Vitreous composes about 80% of the eye. As we age, the vitreous shrinks away from the surface of the retina and is replaced by natural fluids. This is normal and usually does not cause problems. However, if the vitreous is too firmly attached to the retina when it naturally shrinks away, a tear in the retina can occur. This tear is called a ‘macular hole.’ In less common situations, a macular hole may be caused by injury or prolonged swelling of the macula. Macular holes are age-related and occur primarily in patients over the age of 60.
Individuals in the early formation stages of a macular hole experience blurred or distorted central vision. As the hole progresses in severity, a blind spot may develop in the patient’s central zone of vision. This impairs the patient’s ability to see at close and distant range. Peripheral (or side vision) remains undamaged.
The most common and effective form of treatment is ‘vitrectomy’ surgery. Surgeons utilize small instruments to remove any vitreous gel that is pulling on the macula. The space is then filled with a gaseous bubble that flattens the macular hole and holds it in place, allowing the hole to heal. After surgery, patients must orient their heads in a downward-facing position to keep the gas bubble in contact with the macula. The patient must maintain this position anywhere from a few days to several weeks, depending on the surgeon’s recommendation. Risks, restrictions and post-operative requirements will be discussed with your doctor.
As the macular hole heals the eye slowly regains some of the lost vision. The amount of sight recovered after surgery varies from patient to patient.
It is important to schedule regular eye exams with your ophthalmologist to ensure your vision is properly monitored and treated. Contact your doctor to learn more about macular holes and other age-related conditions of the eye.