What is the Retina?
- If the eye were a camera, the retina would be the film of that camera
- The retina is a thin sheet of nerve cells that lines the inside back wall of the eye
- Light travels through the eye and ultimately reaches photoreceptors, the light-sensitive cells in the retina
- The signal from the photoreceptors then travel along the optic nerve to the brain, where the signals are interpreted as vision
What is the Macula?
- The macula is the center region of the retina
- The macula is responsible for high detail vision, central vision, reading, etc. The rest of the retina is responsible for peripheral vision.
- AMD affects the macula, and in turn, results in decreased vision for tasks like reading, driving, recognizing faces, etc.
What is a Macular Hole?
A full-thickness defect (hole) in the macular region of the retina
How does a macular hole affect vision?
- Decrease in central vision
- Dark spot in the middle of the vision
- Missing letters when reading a word
What causes a macular hole?
- Most macular holes are due to abnormalities in the aging process of the eye, whereby tractional forces pull on the fovea at the center of the macula and allow a hole to develop
- Macular holes may also occur in eyes after trauma
How is a macular hole treated?
- Full thickness macular holes may rarely close on their own. In very small macular holes with specific clinical features, a trial of eye drops may help facilitate closure.
- Most full thickness macular holes, however, require surgery for closure
What is macular hole surgery?
- Pars plana vitrectomy
- Outpatient, day surgery
- Micro-incisional surgery whereby the microscopic tissues creating traction on the retina are peeled gently from the fovea and removed. This relieves traction on the hole
- A gas bubble is placed in the eye and patients typically maintain a face down position for several days to help support macular hole closure
- Vision is poor through a gas bubble, but the gas will dissipate on its own, usually over 2-3 weeks (possibly longer if a longer acting gas bubble is used)
Left image: An optical coherence tomography (OCT) scan reveals a full thickness defect in the center due to macular hole. The patient’s vision is 20/200. Right image: An OCT image after surgical repair of the macular hole in the same patient shows closure of the macular hole. Vision improved to 20/40.
