Macular hole surgery

What is a macular hole?

A macular hole is a small gap which opens up in the macula, found at the centre of the retina. The macula is responsible for sharp and detailed central vision. It also plays a key role in reading, writing and recognising colour.

A macular hole tends to occur in people aged from 60 to 80, although it can occur at an earlier age. Only one eye is normally affected but there is a 10% chance that the other eye could develop a macular hole in the future.

The cause of macular holes is not known but it may occur when the vitreous (the jelly-like substance inside the eye) starts to shrink and pull away from the retina and macular at the back of the eye.

What are the symptoms of macular hole?

This condition is painless and can occur without warning. Most patients who have macular hole will notice a gradual loss of central vision, where straight lines appear blurred or distorted (wavy). Reading and performing other routine tasks with the affected eye will often become difficult.

When should I see a doctor?

If a macular hole is left untreated, central vision will often continue to get worse. Evidence shows that early treatment of a macular hole – within months, gives a better outcome to improve vision.

If you experience any of the symptoms described above, you should see your GP or optician as soon as possible. You will typically be referred for consultation with an ophthalmologist.  

What treatments are available?

While some macular holes can seal themselves and require no treatment, surgery is necessary in many cases to help improve vision.

At Circle Health, we can arrange a private clinical appointment for you to visit a leading consultant ophthalmologist who specialises in macular hole surgery using the latest technology. They can closely assess your condition, and advise you about the macular hole surgery that would be most appropriate for you.

About macular hole surgery

Macular hole surgery is a form of keyhole surgery performed under a microscope to close a hole in the macula. This is a tiny part of the retina at the back of the eye that is responsible for controlling central vision, seeing detailed information and colour differentiation.

Before the treatment

At Circle Health, macular hole surgery can be carried out as a day case procedure, usually under local anaesthetic. So you will be awake but will not feel pain or see the procedure. Before your treatment, your consultant will see you a private clinical appointment to assess your individual situation and explain details of the macular surgery.

Macular hole surgery: the procedure

The surgical procedure starts with a vitrectomy, which involves removing the vitreous (jelly-like fluid) from the middle of your affected eye. This will allow your eye surgeon to repair the macular hole at the back of the eye by using the latest micro- instruments and optical equipment to remove any scar tissue that is holding the macular open.

During the procedure, the vitreous jelly is then replaced with a gas bubble, which acts as an internal, temporary bandage that holds the retina in place to help the macula heal. Your body will replace the gas with natural fluids over 3-4 weeks.

When will I recover?

You should be able to leave the hospital a few hours after the procedure. To make sure that the gas bubble is sitting on the correct part of your retina, you may have to have your head positioned face downwards for a few days. This called ‘posturing’ but not everyone will need to do this.

You will receive eye drops to reduce inflammation and prevent infection, as well as instructions on how to care for your eyes after the procedure. Follow-up appointments will also be scheduled to monitor your post-operative recovery. Your eye should take around six weeks to heal.

What are the risks?

Macular hole surgery has a high success rate. Like any surgery, there are some risks associated with this procedure. At Circle Health, your specialist consultant will discuss the benefits and risks of this surgery in a private consultation to help you decide upon your treatment.

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