A hole in the macula causes blurred vision that may lead to a total loss of central vision. Here is a brief overview about the condition and its treatment.
The macula is the highly pigmented spot in the center of the retina. This retinal tissue is responsible for central vision, which is necessary for many activities, like reading, driving, etc. A macular hole denotes a hole or a break in the macula, and results in distorted or blurred vision, which may lead to total loss of central vision, if left untreated. Usually this condition is age-related, and is commonly seen in people, who are above the age of 60. A macular hole is different from macular degeneration, and is also known as retinal hole, retinal perforation, retinal tear, or macular cyst.
What Causes a Macular Hole?
A macular hole is caused by shrinkage of the vitreous, a jelly-like substance that fills the eye. Almost 80 percent of the eye is filled with this substance, which maintains the organ’s round shape. The thin fibers of the vitreous are connected to the surface of the retina. Normally the vitreous is firmly attached to the retina; but as a person ages, the vitreous shrinks and separates from the retina. This separation or pulling away from the retina results in a hole in the macula. Such a macular hole or void gets filled with natural fluids, which cause disturbances in vision.
The shrinking of vitreous sometimes leaves some fibers on the retina itself. These fibers may contract and may lead to a hole in the macula. In some people, such holes may form due to eye diseases, like high myopia, diabetic retinopathy, Best’s disease, or some eye injury or trauma.
Macular holes develop gradually. During the initial stages, the affected person experiences blurred or distorted vision, which may result in more severe problems. There are three stages of macular hole development. Stage I is termed foveal detachment, stage II is known as partial-thickness hole, and stage III denotes full-thickness hole. The severity of the symptoms and the power of vision depends on the size and location of the hole. If not treated on time, it can lead to a detached retina, which in turn may result in total loss of vision. The common symptoms of a macular hole are blurred or distorted central vision, and central blind spot or gray area.
Early detection is an important factor, as far as restoration of vision is concerned. As of now, the only treatment option for a macular hole is surgery. This condition is rectified with a surgery called vitrectomy, which is performed under local anesthesia. Vitrectomy involves removal of the vitreous gel and replacing it using a bubble filled with air and gas. This helps to keep the macular hole intact, by holding its edges in place, until it heals.
Post surgery, it is very important for the patient to keep his face down for some days. In some cases, patients are advised to maintain that position for two or three weeks. This position helps the bubble to press the macula and fill the hole. Gradually, this bubble is absorbed by the body and the natural eye fluids fill the vitreous cavity.
The most common side effect of this surgical treatment is cataract. Others include infections and retinal detachment, which may develop either during the surgery or after that. They are curable. People, who have undergone vitrectomy must avoid air travel. The changes in air pressure can cause problems with the installed bubble.
As mentioned above, early detection is very crucial for proper healing. If detected within six months of its occurrence, the affected person has better chances of vision recovery. In some patients, the hole may seal naturally, but surgery is still necessary to restore vision. It is also observed that, people with a macular hole in one eye, have chances of developing this condition in the other eye too. Regular visits to an ophthalmologist would be beneficial to detect this problem at the earliest, and carry out the treatment for restoration of vision.
Disclaimer: This article is for informational purposes only, and should not be used as a replacement for expert medical advice. Visiting your physician is the safest way to diagnose and treat any health condition.