A macular hole is a hole in the macula. The macula is the part of the retina that is responsible for central vision. This is the part of the eye that we assess when checking your visual acuity, or “20/20” vision.
Macular holes almost always develop during the natural aging process, when the vitreous (the gel that fills most of the eye) thins and separates from the retina.
Since the macula is part of the retina, if the vitreous is too tightly adhered onto the macula, the traction can pull on the macula and cause a hole to form.
Less commonly, macular holes are caused by eye injury, intraocular inflammation, retinal detachment and other diseases. Most cases occur in people over the age of 50.
Macular holes may be asymptomatic in the early stages, but as the macular hole progresses, the symptoms will become apparent as blur or distorted vision. In advanced cases, the vision will drop significantly. Peripheral vision is not affected.
Depending on the cause of the macular hole, surgery can be 95% effective. The outpatient surgery is done with local anesthesia. A vitrectomy is performed to remove the vitreous gel, and then a gas bubble is injected into the eye to help seal the macular hole. As the eye heals, the fluid is naturally replaced. There is currently no non-surgical alternative.
An epiretinal membrane, also called a macular pucker, is a thin layer of tissue that forms over the macula.
Epiretinal membranes often develop on their own as a part of the natural aging process. Particles that have drifted into the vitreous (the gel that fills the eye) settle onto the macula and begin to obscure vision.
Membranes may also result from eye conditions or diseases such as retinal detachments, inflammation, injury or vascular conditions. These are called secondary epiretinal membranes.
Many epiretinal membranes do not disrupt vision. Thicker membranes, however, can create wrinkles or puckers in the macula, resulting in blurry or distorted areas in the central vision. Vision loss increases as the membrane thickens. Peripheral vision is not affected.
For the epiretinal membranes that disrupt your vision, surgery is recommended. The outpatient procedure is performed under local anesthesia. A vitrectomy is performed to remove the vitreous gel, and then the membrane is lifted from the macula. There is no non-surgical alternative.
The retina is a thin sheet of nerve tissue in the back of the eye where light rays are focused and transmitted to the brain. The vitreous is a gel-like substance that fills the eye and is connected to the retina, optic nerve and many blood vessels.
Vitreoretinal surgeries are used to treat various vitreous and retinal diseases and conditions. Risks of vitreoretinal surgeries include a secondary retinal tear or detachment, infection or loss of vision. However, in most cases, surgery is needed to maintain or prevent further loss of vision.
Depending on the type of vitreoretinal surgery, face down positioning may be essential. This allows the retina to heal and may be required for approximately two weeks. Oak Works Corporation provides equipment to facilitate this positioning. This is only required if a gas bubble is placed in the eye. Your face must be kept down ninety percent of the time during this period. Please contact Oak Works for a temporary rental of the equipment which will help maintain your head in the correct position at (800) 916-4592 or online at: www.owleasing.com.
We offer vitreoretinal surgery to correct:
- Vitreous hemorrhage
- Retinal detachment
- Macular pucker
- Macular hole