The human eyes are a marvel of biological engineering, allowing us to see the world in incredible detail and vibrant color. At the heart of our ability to see lies a delicate structure known as the macula, a tiny but crucial part of the retina responsible for our central vision. It allows us to read our favorite books and web content, recognize the smiles and faces of loved ones, and perform countless everyday tasks with precision.
However, like all parts of the human body, the macula is vulnerable to various threats, including the development of macular holes. Untreated, this rare eye condition can have repercussions on a person’s quality of life.
What is a macular hole?
Its definition is straightforward: A macular hole is an opening, cavity, or full-thickness disorder in the macula. It mainly occurs in one eye, although it can affect both eyes simultaneously.
In the center of your retina, the nerve cells are in close proximity to each other. In some cases, the gel-like substance (the vitreous humor) filling the space between the retina and lens of your eyeball changes its consistency. It can shrink and become more liquid, pulling on the macula and causing a macular hole to form.
If a macular hole gets bigger or worsens, it can make the examples in our introduction difficult to enjoy. Can you imagine a world without seeing the beautiful smiles of your friends and family in full clarity? Will you be okay with the idea of encountering difficulties while reading? These are some of the many consequences of untreated macular holes.
How common are macular holes?
This condition affects 7.8 per 100,000 people each year. It is more common among women and people over 55 years old, but it can happen to anyone.
What are the symptoms?
The symptoms of a macular hole typically include:
- Blurred vision
- Distorted vision, such as seeing straight lines as curvy or wavy
- Trouble reading small print
- A dark spot in the middle of your vision, signaling that the macular hole is in an advanced stage
Unfortunately, these symptoms are quite vague and may be indicative of other eye problems. As such, if these symptoms occur or you experience any changes in your vision, schedule a comprehensive eye exam in Sun City, Arizona, as soon as possible.
What causes a macular hole to appear?
A macular hole mostly results from vitreomacular traction (VMT) syndrome, an eye condition where the vitreous humor sticks to the macula. VMT is common in older adults and individuals with certain eye diseases, including those with inflammation within the eye (uveitis) and severe nearsightedness (high myopia). Eye injuries can also cause macular holes to develop.
What are the complications?
An untreated macular hole may cause the following complications:
- Loss of vision, especially central vision
- Retinal detachment associated with a macular hole
- Larger-sized macular hole
Are macular holes and age-related macular degeneration the same?
While macular holes and age-related macular degeneration (AMD) are common in older adults and can have similar symptoms, they are different. If you suspect having one of them and are unsure which condition you have, consult your local ophthalmologist in Phoenix, AZ, as soon as possible, especially since a macular hole and AMD can lead to vision impairment.
Find out more about age-related macular degeneration.
How do eye doctors diagnose a macular hole?
Diagnosing a macular hole involves a slit-lamp examination, which involves using a specialized magnifying microscope to assess the structures of the eye, including the retina, iris, cornea, and vitreous.
Your ophthalmologist may also order these tests to get a closer look at your retinas:
- Optical coherence tomography (OCT): A non-invasive diagnostic procedure utilizing light waves to capture cross-section pictures of the retina.
- Fundus fluorescence angiography (FFA): An invasive diagnostic technique involving the use of a special camera to record blood circulation in the retina.
- Fundus photography: The process of taking photographs of the eye’s interior through the pupil.
What are the treatments for a macular hole?
While discovering a macular hole can be worrying, powerful treatments are available to address the condition. The right treatment depends on the hole’s severity, size, and impact on vision.
Here, we explore the various treatment options for macular holes:
1. Routine monitoring
Not all macular holes require immediate intervention. For example, in the case of small macular holes that do not affect vision, an eye care provider may simply monitor the hole’s progression and evaluate whether it becomes larger or causes symptoms to necessitate treatment.
2. Medicated eye drops
Between 4% and 11.5% of early-stage macular holes heal on their own. If not, an eye doctor may prescribe medicated drops to help them close.
3. Vitrectomy
Vitrectomy is an effective surgical treatment for both small and larger macular holes. During the procedure, a skilled eye surgeon removes the vitreous humor to release traction on the macula. Then, they will replace the gel-like substance with a gas bubble or silicone oil to help the macular hole close and heal.
The gas bubble or silicone oil serves as a temporary internal “bandage” for the hole, holding the edges of the macula in place while it heals. Over time, the body absorbs the gas or oil, and the eye naturally replenishes with aqueous fluid.
After surgery, the eye may be red, swollen, or tender for several weeks. Blurry vision and pain (though manageable with medications) may also persist for a few days. In general, patients will need 2 to 4 weeks to recover before getting back into routines.
The success rate for vitrectomy surgery is over 90%, with patients regaining most or some of their lost vision.
A Final Word
Due to ongoing advancements in ophthalmology, these treatments have shown great success in helping patients with macular holes regain their central vision and enhance their quality of life. If you suspect having a macular hole or any other eye disorder, consult a top ophthalmologist in Sun City and Phoenix, Arizona, to determine the most suitable treatment plan. Contact us at 623-474-3937 to get started with an eye exam.
