Reasons and treatments for macular holes

Most people know clearly that the eye has several parts, e.g. retina, pupil, vitreous humor, cornea and so forth. As the eye’s light-sensitive tissues, retina has a central part called macula. The macula has a sharp point that is critical for some activities such as driving and recognizing faces. Moreover, this eye part is responsible for managing acuity in the eye’s central vision. Unfortunately, macula as well as other ocular parts is quite delicate that some eye diseases have been found in this it. For instance, both macular hole and macular degeneration happen more frequently to people above 60. Macular degeneration is to a certain degree well-known. This writing will focus on the basics of macular hole.

How macular hole differs from macular degeneration?

It is undeniable that macular hole is a different ocular problem from macular degeneration. A well-known fact is that macular degeneration is associated with damage to the retina and its symptoms contain yellow deposits in the macula. Macular holes also occur on the macula, which is situated in the center of retina and responsible for perceiving clear color vision. A difference lies in that a macular hole is a small break in the macula, while macular degeneration is a condition affecting the tissues lying under the retina. In general, these two conditions have no relation with each other.

Possible reasons for macular holes

Contents of the macula include cones and rods. Rods see black and white shading, shape and movement. Macular holes can cause sudden vision decrease in one eye. People’s natural aging brings some changes in the macular contents, so that old people are more susceptible to macular holes. Other reasons for macular holes include vitreous shrinkage or separation, diabetic eye disease, heavy myopia, retinal detachment, Best’s disease and certain eye injuries.

Two direct causes of macular holes due to vitreous shrinkage

Vitreous shrinkage is a major contributor to macular holes. The shape of the eye is maintained by the thick vitreous humor in the back eye, so that aging-caused vitreous shrinkage will cause an effect of pulling off from the retina. In serious cases, this shrinkage can tear a chunk off of the retina, resulting in a hole. The same situation on macula is called a macular hole. Another direct reason for macular holes is the detachment tiny strands of cells from the vitreous. Normal strands connect the vitreous humor and the retina. These strands then contract around the macula, causing macular holes. Both of the two situations bring fluids that fill the macular holes and cause blurry and distorted vision.

Vitrectomy surgery is the standard treatment for macular holes

Macular holes can appear in three stages and in most cases an external intervention is needed. Without an inappropriate treatment, about 50% of foveal detachments worsen and 70% of partial-thickness holes worsen, while most full-thickness holes will deteriorate.

For macular hole treatment, the best way is to remove the vitreous gel to stop it from pulling on the retina. Vitrectomy is the right procedure, during which the specialist will insert a bubble of air and gas into the vitreous space, in order to put pressure on the macular hole’s edges and heal it. This process takes as long as two to three weeks, because you should lie face down so that the bubble stays in the right place in the eye. The bubble goes away over time and eye fluids will restore.

The surgery has some risks

Risks of a vitreous surgery include eye infection, retinal detachment and cataracts. Cataracts can occur immediately after a vitrectomy procedure. Patients who have received vitrectomy using a gas bubble should avoid air travel within several months, because pressure changes in the plane may cause gas expansion.