Macular Hole - recommended vitrectomy

[Lyosha]

I have had two retinal tears repaired with laser and later developed a macular cyst in my right eye.  About 7 months ago I noticed a slight change in vision in the right eye and changed from bifocal contacts to monovision with distance vision in the right eye.  I went to my retinologist the other day and he found that my cyst had opened into a macular hole.  He recommends that I have the cataract in my right eye removed, then four weeks later vitrectomy with head down immobilization for 2-4 weeks.  I really trust the doctor and know he is an expert in his field, however.....

I just wonder what would happen if I decided not to have the vitrectomy.  Right now, I just have blurred vision in the right eye, some difficulty with seeing faces at 20 feet or so. I know that the success of the surgery depends on catching it early.  I have a feeling that I have had this hole for more than 7 months.  As I understand, the surgery is most successful in the first 2-3 months after the hole develops.   I think I have missed this window.

I hate the thoughts of immobilization and the head down thing - my household is busy with dogs and a new puppy.  I won't be able to travel by air for a while and I just don't want to leave the responsibilities all to my wife and son.  I find myself very depressed about the thoughts of this and dreading it terribly.  What's the worst that could happen if I declined the surgery?

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

Get a second opinion from another retina/macular ophthalmologist. The worse thing that could happen is the hole gets bigger and deeper and your vision drops to 20/400 or worse and surgery would no longer help. there would also be a small risk of a retinal detachment from a full thickness macular hole

JCH MD

[Lyosha]

Oh, I am 59 years old. - Lyosha