![]() ![]() Stages 2, 3, and 4 represent, respectively, formation of a true hole, enlargements of the macular hole, and separation of the vitreous from the retina. Approximately 50% of Stage 1 macular holes disappear without surgery. Patients with a Stage 1 macular hole typically have little or no visual loss. Stage 1 is a macular hole of partial thickness separation of the retina that is, it does not extend all the way through the retina and is not a true hole. ![]() A staging system is used to describe this amount of separation. Q: Do holes ever disappear without surgery?Ī: It depends largely upon the amount of separation of the vitreous from the retina present in the macular hole. Q: Is there a laser treatment for macular holes?Ī: No, only surgery can repair a macular hole. Q: Is there a medication for the treatment of macular holes?Ī: No: there is no medicine, eye drop, vitamin, herb, or diet that is beneficial to macular hole patients. Our doctors do not use these substances because there is no scientific evidence of their benefit, there is potential risk, and many experienced surgeons no longer use these agents. Most but not all surgeons peel (“strip”) this tissue away from the retinal surface during vitreous surgery.Ī decreasing number of surgeons place blood products such as serum, clotted blood, or platelet concentrate on the retinal surface. The tissue on the retinal surface may be residual vitreous, epiretinal membrane, or ILM. Vitreous surgery consists of removing the vitreous to enable injection of a large gas bubble and, in many instances, peeling of tissue from the retinal surface to stimulate hole closure. Q: What is the treatment for macular holes?Ī: Vitreous surgery, placement of a gas bubble inside the eye, tissue peeling using forceps (FORM), and head down positioning for several weeks after surgery are required to repair macular holes. The odds are about 6% of developing a hole in the second eye. Q: If one eye develops a macular hole, will the other eye develop one?Ī: Usually not most patients develop holes in one eye only. Q: Are eye strain, nutrition, general health, smoking or emotional stress related to macular holes?Ī: No, there is no known relationship between macular holes and any of these problems. Q: Does hardening of the arteries cause macular holes?Ī: No, circulation problems have not been shown to have any relationship to macular holes. These holes typically have no cuff of fluid around them and are associated with retinal “wrinkles”. Some macular holes are caused by a thin layer of tissue known as an epiretinal membrane. Residual vitreous humor remaining on the retinal surface after this event probably contracts, pulling on the macula and fovea in an outward direction. Q: What is the cause of classic macular holes?Ī: Most classic macular holes are apparently related to posterior vitreous separation. They are three times as common in women as in men, for unknown reasons. Patients with holes of this type should not be treated with surgery.Ī: Classic macular holes are a moderately common cause of irreversible central visual loss in people over age fifty. Macular holes caused by long-standing macular edema (swelling), which can be caused by diabetic retinopathy, branch vein occlusion, pars planitis, or other inflammatory eye disease.Surgery is less successful in this group but can be performed if the doctor thinks the retina and underlying retinal pigment epithelium are functioning well. Some of the traumatic cases spontaneously heal (“close” or “seal”). Traumatic macular holes: these usually occur with direct impact occurring on the eye or head.These are of the type that will likely benefit most from surgery, if certain criteria are met. Classic macular holes: also called idiopathic or degenerative macular holes, these are much more common than other types.Q: Are there different types of macular holes?Ī: Yes, they fall into the following categories: Q: Can macular holes cause total blindness?Ī: No, they can only cause loss of central vision. Other eye problems can cause similar symptoms the presence of a macular hole can only be determined by a dilated eye exam. The center of the macula is called the fovea.Ī: A macular hole is a defect in the macula.Ī: They are decreased or complete loss of central vision. It is responsible for central vision (straight ahead vision), your best vision, and most color vision. A: The macula is the center of the retina. ![]()
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