Macular hole surgery questions

I just was diagnosed yesterday with a  macular hole in my right eye. I am a 63 year old female and 2 years ago I had a corneal cyst in the same eye which healed on its own.

The symptoms I experienced recently were very simily to the cyst and I thought it had come back. It has only been about a month or so since first noticing blurring vision in that eye.  So I was surprised with the diagnosis of a macular hole.  My doctor says the hole is very small and recommended the surgery. To read the eye chart with that eye, I could see the letters if I looked slightly to the right of the letter, so it makes sense it must be very small. With both eyes, I don't seem to have too much trouble, just with reading under low light. I was told what I have read here,  that the hole will not repair itself and could get worse and that the surgery should be sooner rather than later.  Also he told me it won't correct my vision completely.

But after describing the surgery and post operative face-down requirement, I am very nervous about undertaking this surgery.  My eyes are very sensative to light. In fact I never wore contact lenses because I had a problem with putting them in my eye. The fact I have to be awake for the surgery is terrifying for me. Also the healing period of having to keep the head down for 7 to 10 days or maybe longer sounds very difficult to do.

I don't want to lose the vision in my right eye at 63. I suppose what I am asking for is some encouragement that the risks in this surgery are worth the possibility it might not help and I may develop cataracts sooner rather than later.

[Sandy Feldman, MD, MS]

Dear cimgraph,

Macular hole surgery can assist in repairing the hole.  The amount of visual improvement will depend upon the size of the hole and the length of time that it has been present.  While the vision may not correct itself fully, and complications can occur with vitrectomy, your eyeMD will determine the benefits and risks of such treatment for your particular eye.  It is normal to have some trepidations and by educating yourself and speaking with your eyeMD you will be more knowledgeable about what to expect.

Dr. Feldman

Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California

[gigs924]

I, too, was very nervous about being awake for the surgery and the face-down positiioning.  I was concerned about being motionless for the surgery.  That was not a problem at all.  I am assuming it was because of the drugs.  The face-down wasn't easy.  After the first two hours, I thought "what have I done"  It got easier.  I rented a chair to rest my head on and a board to lay my head on during sleep.  There are several companies that rent this equipment online.  After 5 days I called the dr. because my neck hurt so badly and he prescribed tylenol with codeine.  That was my major problem.  Being prepared for it ahead of time is essential.  Check online for macular hole surgery and you will find lots of information, even a video of an actual surgery if you can handle that.   Good luck with your surgery.!

[cimgraph]

Thanks for the encouragement.  You made me feel better!  I am feeling somewhat more confident after reading the numerous posts here that I can handle this.  I've come to the conclusion that sometimes these things just happen and we have to deal with them. My doctor's office gave me the literature on the the chair rest and sleep aid and my husband knows he has a chance to rack up major brownie points here!  Thanks again.

[gigs924]

I should have mentioned stock up on drinking straws because you won't be able to drink otherwise.  I put several jogging suits on a low rack so I could reach them along with a days change of clothes.  I bought cheery colors--pink, yellow, apricot, turquoise, etc. at  Wal-Mart to  have easy to change and cheery to look at and comfortable to wear.  If you are fortunate to have a partner who will give you a neck rub occasionally that would be wonderful.  My daughter brought me a pair of house slippers with monkeys on the toes to look at.  (I'm 65)  Pulling for you !!!!

[cimgraph]

Thank you, Dr. Feldman for your reply.  I have been doing some reading on my own in the last few days and understand the procedure a bit more.  I do want to get a second opinion regarding how soon to have the surgery. After that, I will make my decision and schedule the surgery. I do understand that all patients are different and the object of the surgery seems to be to stop the hole from enlarging and possibly helping my central vision in that eye even if it won't return to normal. Also that some of the success of the operation will depend on my diligence post op in the head down position.

Thank you for all of your comments and tips. This is a wonderful education resource.

[cimgraph]

Well, my vitrectomy is scheduled in one week on April 7, 2009. I have an appointment with my surgeon this week to go over the surgery details and a chance to have my questions answered. I have contacted Vitrectomy Solutions to work out rental of equipment for the face down post operative period.  From what I have read, it seems to be one or two weeks of face-down positioning.  I'm still nervous about the surgery, but I have taken all the tips to heart that I have read here on this forum and will hope for the best.  Since my macular hole is small, I am hoping I have a good chance of  healing quickly.  I will certainly do my part to speed it along.

I will post updates of my recovery since I found others' posts very helpful.  Wish me luck!

[valvay]

A related discussion, MACULAR HOLE SURGERY was started.