epiretinal membrane early diagnosis help with treatment recovery?

[ortholab]

I have always been very near-sighted and my left eye has always been my weaker eye. In 2010 I was hit by a car. Afterwards, for at least 6 months, the vision in my left eye seemed tilted. Eventually it corrected, or my brain calibrated for it(my theory) - they could never prove anything was physically wrong with the position of my eye. I would have had to have an MRI or ultrasound done BEFORE the accident to prove anything(who does that?)  One year later I was diagnosed with epiretinal membrane in my left eye, and was monitored every 6 months by the eye doctor that the Insurance company sent me to. He never suggested seeing a specialist, just told me to study a grid/graph paper, and to tell him if I saw any changes. Last August he told me I was fine there's probably nothing to worry about.
I have since then found my own Retina Specialist. I've had ultrasounds done of both eyes and it is in both eyes, though the left is worse, and I never would have guessed it was in the right.(because of the accident I tend to rely on my right eye and ignore the quirks of the left one). I am now seeing Dr. Jabbour ever 6 WEEKS, and he says to let him know(after only two visits) if I "lose a piece of my vision, to call them immediately" - it means the membrane has torn a hole in my eye!
My question is: If I had been sent to Dr Jabbour or someone like him 2 years ago, would I be any better off than I am now? My pictures look like and my report states that I HAVE a "macular hole formation". And he has told me that there is no certainty that after surgery (whenever THAT is) that the hole will heal back together. He says it is too soon for surgery, we'll just monitor it every 6 weeks. My co-worker who used to work for him said I don't want to have the surgery "too soon" - at this point I don't think that statement applies - "too late"" is what I'm seeing in those pictures, but I'm not a doctor, I'm just the subject, I can't see the forest for the trees.Surgery will relieve the stress making the tear, and no one can rule out that it (the epiretinal membrane) won't recur, but no one knows if the damage (hole) on the ultrasound will heal over time. At this point I can believe that surgery will prevent further damage, but what damage there is, is likely permanent. My vision is slightly distorted, but I can still type on the computer O.K.(obviously). I'm grateful that my job is not computer based, but it will be affected by this, in time.
Thank you for your time and help.

[ortholab]

Hello again,
I've been analyzing this whole thing and stuff I've gone through, throughout life, trying to understand if, over a period of time this problem has developed due to certain events/ illnesses/ physical tendencies? In comparing my ultrasound to the images online, except for the hole my eye looks fairly normal.The membrane is not that obvious.
Today's question: Has it ever been documented that a person was BORN with a macular hole, and they never realized it till some other event (accident/MRI) discovered it? I have an MRI from the accident that happened in 2010, and I'm going to share it with my retina specialist, maybe it will help him treat this(?). The eye doctor at the time ordered it to check for brain stem trauma, I was born with Ptosis in my right(good) eye. He never ASKED anyone about it he thought the accident caused it, so he scheduled an MRI. I've never actually seen it, but I made sure that I had a copy of all records, especially the MRI. I won't see my Retina Specialist again till mid-April, so I won't have any answers till after that. I will be sure and ask him about the medicine Jetrea,and if it could help in my situation.
Thank you again, for everything,
ortholab

[ortholab]

Hello again,
I've been analyzing this whole thing and stuff I've gone through, throughout life, trying to understand if, over a period of time this problem has developed due to certain events/ illnesses/ physical tendencies? In comparing my ultrasound to the images online, except for the hole my eye looks fairly normal.The membrane is not that obvious.
Today's question: Has it ever been documented that a person was BORN with a macular hole, and they never realized it till some other event (accident/MRI) discovered it? I have an MRI from the accident that happened in 2010, and I'm going to share it with my retina specialist, maybe it will help him treat this(?). The eye doctor at the time ordered it to check for brain stem trauma, I was born with Ptosis in my right(good) eye. He never ASKED anyone about it he thought the accident caused it, so he scheduled an MRI. I've never actually seen it, but I made sure that I had a copy of all records, especially the MRI. I won't see my Retina Specialist again till mid-April, so I won't have any answers till after that. I will be sure and ask him about the medicine Jetrea,and if it could help in my situation.
Thank you again, for everything,
ortholab

[John C Hagan III, MD, FACS, FAAO]

Good question and you realize there are no stock answers and each case is different.
1. Many holes remain small, do not effect the vision and the risk of surgery outweights "watchful waiting"
2. Some patients are to sick to have the surgery, have a limited life expectancy, have severe mental illness (severe Alzheimeer's) that preclude surgery.
3. Some people refuse the surgery because they cannot accept the risk or pray it won't get worse.
4. Some people know someone that had "a bad result" and they are scared and refuse.
5. There may be other eye disease such that a perfect operation on the macula will not improve the vision much example retinitis pigmentosa
6.THERE IS A NEW MEDICINE JETREA  http://jetrea.com/  THAT BY INJECTION INTO THE EYE MAY RELEASE TRACTION ON THE HOLE AND PREVENT SURGERY. THIS IS A MAJOR ADVANCEMENT.

JCH MD

[ortholab]

Thank you for your reply. I was reading Jodi's posts which as why I wrote my letter. I'm new to this field but I' trying to be better informed, though at this point I think it's like closing the barn after the horse has fled. Today's question  -  If I already have a "macular hole", HOW can it be possible to have surgery "too soon"? Delaying surgery till it was unavoidable, I understand, but I thought we were running the risk of a tear in my eye before the surgery. Now I find out it's already happened.(I haven't lost "a piece" of my vision YET, as they told me to watch out for). What's the point/benefit of delaying surgery?
Thank you again for your help,

ortholab

[John C Hagan III, MD, FACS, FAAO]

No one can answer your questions about "what if", it's conjecture and no one can tell you for sure. Use the search feature and archives to read the many posts about epiretinal macular membranes especially those by JodieJ who is very articulate and underwent a membrane peel.

JCH MD