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doing nothing for a macular hole
What are the ramifications of not having the surgery to correct a macular hole in the eye? Will it enlarge or stay the same size? Will the vision continually deteriorate to blindness in that eye? The surgery results from the people on this forum don't seem too encouraging.
Dear maffuc,
My ophthalmologist told me that it is important to have surgery ASAP to correct a macular hole.
June 30th was the one year anniversary of my surgery, and I can tell you that my eyesight has returned to about 95% of the original vision.
Here is a diary of my procedure that I posted last year....
Week 1 - I had my vitrectomy on a Monday. The procedure was only 45 minutes. I was taken to the operating room at 8:30 am, and was on my way home before noon. I had gone to the website http://www.kellycomfort.net/vitrectomy/ and rented equipment to help me remain the face-down position. I found this very beneficial. (There are a number of other websites that offer similar equipment.) The morning after the surgery I returned to the doctor's office, (my wife was my chauffeur), and they removed the bandage. When they tested my eyesight the vision in my affected eye was a large opaque circle, which was the gas bubble. During the first week the bubble diminished in size and my vision actually got worse. The first day I could see very vague images through the bubble, but when the bubble began to shrink, I saw red on the perimeter of the shrinking circle, and images became almost indistinguishable. I discovered later that the red color was post-operative bleeding inside the eye. (The more the bubble shrank, the worse the vision got.) The first week after the operation I used the protective shield that I was given to protect the eye, but only at night when sleeping. During the week I was able to eat my meals, watch TV, work on my laptop computer, and do crossword and Sudoku puzzles, all in a face-down position. The only activities that weren't completely face-down were brushing teeth, shaving and showering. (My doctor said I was permitted to do these activities.)
Week 2 - I went to the surgeon eight days after the surgery. The bubble inside the eye was about 60% of the original size and my vision was actually worse than the day after the surgery. When the doctor looked at my retina he could not see if the hole had been closed because of post-operative bleeding inside the eye. The doctor told me that my condition was "normal" and that I could not expect to see much at this point in time. I was also told that I could return to an upright position, but still was on a schedule of minimal activity. During the second week I was able to take the dog for his daily walks, go to a friends house for a 4th of July celebration, and attend a wedding and reception. (I did dance with my wife, but only slow dances.) My eyesight still was nonexistent in the affected eye for the entire week and I could only see opaque images. I must admit that the first two weeks were very difficult for me, and I would consider myself as usually optimistic.
Weeks 3 and 4 - The morning of the 14th day after the surgery my bubble was totally gone, and I returned to the surgeon on the 17th day after the procedure. Once again he could not see if the macular hole had been sealed because of the blood in the eye. The good news was that I was allowed to return to a full schedule of activity. My vision had improved very slightly from the week before, and the opaque images were still indistinguishable. The good news here is that once I was able to return to my normal activities, I was able to notice slight improvements on an almost daily basis. I was able to begin driving, and did not feel that my depth perception was affected too severely, but I did drive a little slower and more cautiously. I went golfing, walking 9 holes the first two times and 18 after that. (I did have some depth perception problems here, not knowing how high to tee the ball, so I hit most of my drives with and iron or hybrid with minimal tee height.) My personal observation was that when I put in a full day of work, the eye would definitely show improvements the following morning. I also was able to view an Amsler grid during week 4, and did not see the wavy lines that I had experienced when the macular hole was discovered.
My next visit to the surgeon came on the 31st day following the vitrectomy, and I am happy to report that I was able to see the top 5-6 lines on the eye chart. The surgeon also said that the macular hole had successfully been sealed. He also said that the retina would take 8 to 9 months to completely heal and for the blood to be absorbed into my system. For this period of time I should expect some glare and distortion, but my eyesight should continue to improve.
It is now 8 weeks following my vitrectomy, and I recently went to the retinal surgeon. He said my eye looks, "Great!" I was told to go to my opthalmologist in 3 to 4 weeks for a complete eye examination. While my eyesight continues to improve, it still has some distortion, but I am encouraged by the prognosis.
And here is additional information...
At 5 months I went to the ophthalmologist and had an encouraging checkup, in that, the macular hole had been sealed. However, I now had a cataract in the eye that had the vitrectomy. In truth, the retinal surgeon had told me that this would inevitably happen.
Seven months after the vitrectomy I had cataract surgery. The procedure lasted less than an hour and I was home before noon. I returned to work in three days, and my eyesight is about 20-40.
While you mention in your posting that there have been some discouraging comments from people on this forum, I am here to tell you that my surgery, while difficult at times, saved my eyesight.
Best wishes,
Dan415
My ophthalmologist told me that it is important to have surgery ASAP to correct a macular hole.
June 30th was the one year anniversary of my surgery, and I can tell you that my eyesight has returned to about 95% of the original vision.
Here is a diary of my procedure that I posted last year....
Week 1 - I had my vitrectomy on a Monday. The procedure was only 45 minutes. I was taken to the operating room at 8:30 am, and was on my way home before noon. I had gone to the website http://www.kellycomfort.net/vitrectomy/ and rented equipment to help me remain the face-down position. I found this very beneficial. (There are a number of other websites that offer similar equipment.) The morning after the surgery I returned to the doctor's office, (my wife was my chauffeur), and they removed the bandage. When they tested my eyesight the vision in my affected eye was a large opaque circle, which was the gas bubble. During the first week the bubble diminished in size and my vision actually got worse. The first day I could see very vague images through the bubble, but when the bubble began to shrink, I saw red on the perimeter of the shrinking circle, and images became almost indistinguishable. I discovered later that the red color was post-operative bleeding inside the eye. (The more the bubble shrank, the worse the vision got.) The first week after the operation I used the protective shield that I was given to protect the eye, but only at night when sleeping. During the week I was able to eat my meals, watch TV, work on my laptop computer, and do crossword and Sudoku puzzles, all in a face-down position. The only activities that weren't completely face-down were brushing teeth, shaving and showering. (My doctor said I was permitted to do these activities.)
Week 2 - I went to the surgeon eight days after the surgery. The bubble inside the eye was about 60% of the original size and my vision was actually worse than the day after the surgery. When the doctor looked at my retina he could not see if the hole had been closed because of post-operative bleeding inside the eye. The doctor told me that my condition was "normal" and that I could not expect to see much at this point in time. I was also told that I could return to an upright position, but still was on a schedule of minimal activity. During the second week I was able to take the dog for his daily walks, go to a friends house for a 4th of July celebration, and attend a wedding and reception. (I did dance with my wife, but only slow dances.) My eyesight still was nonexistent in the affected eye for the entire week and I could only see opaque images. I must admit that the first two weeks were very difficult for me, and I would consider myself as usually optimistic.
Weeks 3 and 4 - The morning of the 14th day after the surgery my bubble was totally gone, and I returned to the surgeon on the 17th day after the procedure. Once again he could not see if the macular hole had been sealed because of the blood in the eye. The good news was that I was allowed to return to a full schedule of activity. My vision had improved very slightly from the week before, and the opaque images were still indistinguishable. The good news here is that once I was able to return to my normal activities, I was able to notice slight improvements on an almost daily basis. I was able to begin driving, and did not feel that my depth perception was affected too severely, but I did drive a little slower and more cautiously. I went golfing, walking 9 holes the first two times and 18 after that. (I did have some depth perception problems here, not knowing how high to tee the ball, so I hit most of my drives with and iron or hybrid with minimal tee height.) My personal observation was that when I put in a full day of work, the eye would definitely show improvements the following morning. I also was able to view an Amsler grid during week 4, and did not see the wavy lines that I had experienced when the macular hole was discovered.
My next visit to the surgeon came on the 31st day following the vitrectomy, and I am happy to report that I was able to see the top 5-6 lines on the eye chart. The surgeon also said that the macular hole had successfully been sealed. He also said that the retina would take 8 to 9 months to completely heal and for the blood to be absorbed into my system. For this period of time I should expect some glare and distortion, but my eyesight should continue to improve.
It is now 8 weeks following my vitrectomy, and I recently went to the retinal surgeon. He said my eye looks, "Great!" I was told to go to my opthalmologist in 3 to 4 weeks for a complete eye examination. While my eyesight continues to improve, it still has some distortion, but I am encouraged by the prognosis.
And here is additional information...
At 5 months I went to the ophthalmologist and had an encouraging checkup, in that, the macular hole had been sealed. However, I now had a cataract in the eye that had the vitrectomy. In truth, the retinal surgeon had told me that this would inevitably happen.
Seven months after the vitrectomy I had cataract surgery. The procedure lasted less than an hour and I was home before noon. I returned to work in three days, and my eyesight is about 20-40.
While you mention in your posting that there have been some discouraging comments from people on this forum, I am here to tell you that my surgery, while difficult at times, saved my eyesight.
Best wishes,
Dan415
MEDICAL PROFESSIONAL
Dear maffuc,
The success of surgery to correct the macular hole can depend upon the size of the hole and the length of time that it has been present. It will also depend upon the vision and symptoms before the procedure.
Dr. Feldman
Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California
The success of surgery to correct the macular hole can depend upon the size of the hole and the length of time that it has been present. It will also depend upon the vision and symptoms before the procedure.
Dr. Feldman
Sandy T. Feldman, M.D., M.S.
ClearView Eye and Laser Medical Center
San Diego, California
Doing nothing for a macular hole is risky, but then again so is surgery. Many macular holes if left untreated can become worse and cause you to experience worsening central vision. If you've had the hole for less than 6 months surgery will yield better results than if the hole has been present for a longer time. Also, note that there is an increased risk for your other eye developing a hole as well and cataract formation in the affected eye is high.
Surgery, for macular holes can be and is successful. Just don't expect miracles. More than likely your vision will still be a bit distorted after surgery, but it will be far better than with the hole.
The best thing to do is talk with your surgeon about the risks and benefits of the surgery. As well as what is generally expected in terms of final visual acuity after surgery.
Surgery, for macular holes can be and is successful. Just don't expect miracles. More than likely your vision will still be a bit distorted after surgery, but it will be far better than with the hole.
The best thing to do is talk with your surgeon about the risks and benefits of the surgery. As well as what is generally expected in terms of final visual acuity after surgery.
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