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macular hole
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macular hole

i have been diagnosed w/a macular hole in my left eye retina----------explain what it is and especially explain what sugery to repair it involves as well as length of recovery
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711220_tn?1251894727
A hole in the retina can occur due to aging changes.  Most holes develop in the peripheral retinal.  Some of these can lead to a retinal detachment.  Rarely, the the hole occurs in the the macula.  The area for central vision.

Surgery removes the vitreous and traction on the macula.  If successful, vision is restored.  The amount of visual restoration depends on the how soon it is repaired and the amount of reattachment.

Dr.O.
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I just have macular hole operation July 20, am terrified that my vision will not be restored.  I am 57 and otherwise healthy.  Can you tell me how your eye is healing?  
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553722_tn?1217291977
Dear ala310:

Here is a diary that I submitted to MedHelp about my macular hole.  I hope your surgery was a success and that things are progressing well for you. I hope this diary gives you an idea of what is ahead. All I can say is that the recovery is a S-L-O-W process, but to have your eyesight returned is truly a God-given gift!

My macular hole was discovered the second week of June, 2008, and the surgery was June 30th.....

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 the 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.

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 go to a friends house for a 4th of July celebration and I also went to a wedding and reception.  (I did dance with my wife, but only slow dances.)  My eyesight still was minimal at best 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, but 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, 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 reabsorbed into my system.  For this period of time I should expect some glare an distortion, but it should continue to improve.  Following that I can expect to have a cataract develop, but once that is corrected, I should have normal eyesight.

My last visit to the retinal surgeon was two months after the surgery. My vision was still blurry and the blood reabsorption was progressing steadily.  He pronounced that the retina looked fine and was happy with my progress. He did warn that I would eventually need cataract surgery. He then told me to make an appointment with my ophthalmologist in approximately 3 to 4 months.

I made an appointment with my ophthalmologist that was a little more than 5 months after my vitrectomy.  She did a thorough exam and told me that I did, indeed have a cataract. She then presented me with options that I could be fitted for glasses or I could undergo eye surgery.  I have several friends who had cataract surgery, two of them did not need any glasses following surgery after having worn them since junior high school, so the choice was obvious and I told her that I wanted the surgery. She then measured my eye and gave me the options for the lens that she would be implanting. I went with her recommendation.

Almost 7 months to the day I had cataract surgery an an outpatient clinic. I went in at 7:00 in the morning and was home by 10:30. The first 12 hours after the surgery I had double vision due to the drugs, and the vision in my corrected eye was darker than normal for 24 hours, again because of drugs used in the operation. My followup vision to the ophthalmologist the day after the surgery was encouraging. She said that the operation went like clockwork. She then looked at my retina and said that things looked great, and that an eye specialist would have a hard time detecting the fact that I had ever had a macular hole.

My next visit was a week after the surgery, and all was fine.  

And, at my next visit, 3 weeks later, my corrected eye was almost 20-20.  Now, I can look at the Amsler Grid and see very slight distortion with my affected eye, while the other eye is perfect.  I do suspect that this is caused by the surgery to the hole in my macula, rather than the hole itself.  I do have to say that with each passing week and month the affected eye keeps getting stronger and stronger.

It was a long 9 months, and I am very thankful for the miracles of modern science that helped me regain normal sight.

Dan415
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