Over the last two decades, macular hole diagnosis and treatment have undergone dramatic transformation. A combination of clinical examination with OCT is key for successful anatomical closure and functional results.
Many macular holes will eventually close on their own; for those that don't, surgery known as vitrectomy may help restore vision in most people with an idiopathic full-thickness macular hole. An eye surgeon will be better able to guide you on the surgery and its process!
Diagnosis of Macular Hole
If you experience blurred or distorted central vision, or notice a black spot in the center of your visual field, seek advice from an eye specialist or GP immediately. Macular holes can lead to loss of central vision and eventually retinal detachment.
Macular holes occur when the vitreous jelly (vitreous jelly) filling your eye begins to shrink, pulling away from its place against your retina at the back. They may be caused by trauma; however, in most cases they occur without apparent cause.
Your eye doctor will review your complete medical history, then prescribe drops to dilate your pupils for a thorough eye exam using optical coherence tomography (OCT). He can then identify macular holes by using this specific scanning test and assess its size; additionally they may perform a special procedure whereby a gas bubble will be placed inside your eye to press against it and help close any existing ones.
Macular Hole: Treatments
Macular hole treatments typically include surgery. During this procedure, eye doctors remove clear gel-like fluid (vitreous jelly) from within the eye, peel a membrane on the retina (internal limiting membrane) and insert a gas bubble to close retinal holes and improve or maintain central vision clarity; however, full normal vision restoration cannot always be guaranteed in such patients.
Success of macular hole surgery depends upon a number of factors, including age, duration of the hole, size of the hole and type of hole. Long standing and larger holes have poorer chances of vision gain. For this reason it's essential that any changes to central vision be reported immediately to an ophthalmologist or optometrist.
Attaining optimal eye health requires managing health conditions like diabetes that could threaten it, and eating foods rich in antioxidants such as papaya spinach and carrots support healthy vision.
Post Macular Hole Surgery Care
Macular holes disrupt central vision and make reading and driving difficult, since they occur in the macula part of your retina that allows for seeing straight lines and colors but are treatable and don't usually result in permanent blindness.
After surgery, your eyes must remain in one specific position (usually face-down) for a day upto a week ; depending on its size.
Regular visits with your eye doctor are key in maintaining optimal eye health, especially if you suffer from conditions like diabetes or high blood pressure that impact it. Eating healthily and quitting smoking are also recommended for improving overall eye wellness.
Care Coordination
Macular holes may be managed conservatively without surgery in some instances. Your eye doctor can advise on this matter depending on your symptoms and the way in which your central vision has been compromised.
Macular holes can have an adverse impact on central vision, making straight lines appear crooked or wavy and making reading or driving difficult. They do not affect peripheral (side) vision.
The surgery is generally successful and leads to improved central vision. However, due to its potential risk for cataract and retinal detachment formation over time, regular check-ups with your eye doctor should continue as part of the treatment plan.
Those suffering from macular holes should notify their employers in order to facilitate reasonable accommodations if their central vision changes, which may require you to stop driving due to changes. Air travel should also be avoided since the gas injected into your eyes during procedures may expand at high altitudes and cause irreparable damage.
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