Vision Scotland : Everything you need to know
Macular holes
Transform your vision with fast, precise
and painless laser eye surgery treatment.
Transform your vision with fast, precise
and painless laser eye surgery treatment.
The retina in your eye is similar to the photographic film in a camera, composed of multiple layers of nerve cells. The function of the retina is to turn images of the outside world into signals, which are then transmitted to your brain. The macular is located at the centre of the retina and has the important function of providing you with high definition vision – for things like reading and recognising faces. A macular hole is a defect that goes all the way through the retina, at this very location.
Patients with a macular hole will experience blurring of close up objects, and straight lines like doorways may also appear curved or bent. For some, particularly in the early stages of a hole developing, the symptoms are subtler, and it will only be noticeable when one eye is closed. It is a condition where time is of the essence for treatment, because as the hole gets bigger, so the surgical success rate in closing it gets smaller.
It is unclear why macular holes form. However, there are risk factors for their formation and these include age, female sex, and short-sightedness.
Treatment for macular holes requires keyhole surgery to the eye. The operation is typically performed under a local anaesthetic. During the operation the surgeon removes the gel from inside the back of your eye as well as the inner limiting membrane which pulls on the retina. A bubble of gas is then placed inside the eye to encourage the macular hole to close.
Sometimes the surgical openings are closed with a small stitch at the end of the operation, but these dissolve after 4 to 6 weeks. You will usually have a pad and shield over your eye after the operation which is removed the next day.
Surgery is very successful and overall 90% of macular holes close with a single operation. Most patients find that surgery either improves their vision or stops it from getting worse, however, the quality of vision is never as good as it was before the macular hole, even if the operation is successful.
Small macular holes that are detected early tend to fair much better than large holes that may have gone undetected. It is for this reason, prompt diagnosis and surgery provide your eye with the best chance to preserve vision.
The surgery is considered low risk and low impact, but your eye will feel uncomfortable, gritty, and itchy for a week or two. It may also look red or bruised. Regular pain relief is usually enough to treat the discomfort.
You will receive eye drops to reduce inflammation and prevent infection. Your eye will heal over the next 6 to 8 weeks but your vision might continue to improve for several months following the surgery. If a retinal tear develops during surgery your surgeon may put a bubble of gas inside your eye to stop the retina from detaching. In this case you may have to posture with your head in a certain position, and your vision will be blurry until the gas disappears.
You must not fly until the gas has disappeared as the bubble will expand and damage your eye. You must also not have nitrous oxide anaesthetic for the same reason. It is normal to have some discomfort after any operation, but you should contact Vision Scotland should you have any concerns.
All surgery is carried out by the same surgeon you see in consultation.
Our surgeons are all highly experienced with more than 10+ years’ experience in refractive surgery.
Experienced, caring nursing and optometrist team.
HIS approved purpose-built facilities.
State-of-the-art diagnostic and surgical equipment.
Robust, extended aftercare plans as part of package.