Macular Hole

Symptoms of Macular Hole

The symptoms of a macular hole can vary in severity and may develop gradually. Some common symptoms include:

• Blurry or Distorted Central Vision: The most prominent symptom is a decrease in central vision clarity. Objects may appear blurry, distorted, or wavy, especially when looking directly at them.
• Central Blind Spot: A macular hole can create a central blind spot in the visual field, making it difficult to focus on objects directly in front of you.
• Difficulty Reading or Performing Detailed Tasks: Due to the loss of central vision, tasks that require fine detail, such as reading, writing, and threading a needle, can become challenging.
• Visual Distortions: Straight lines may appear bent or distorted, and objects might appear larger or smaller than they are.
• Reduced Colour Perception: Some individuals may notice a decreased ability to perceive colours accurately.

Treatment of Macular Hole

Treating a macular hole depends on its stage, size, and the individual's overall eye health. The main treatment options include:

• Vitrectomy Surgery: Vitrectomy surgery is often recommended for larger or more advanced macular holes. During this procedure, the vitreous gel inside the eye is removed, and the hole is repaired. This involves carefully peeling the ILM from the macula and often filling the eye with a gas bubble to support the hole's closure as it heals.
• Gas Tamponade: In conjunction with vitrectomy surgery, a gas bubble might be injected into the eye to press against the macula and promote its healing and closure. The patient may need to maintain a specific head position for some time to allow the gas bubble to exert pressure on the hole.
• Face-Down Positioning: After surgery with a gas tamponade, patients might be required to maintain a face-down position for several days to ensure proper positioning of the gas bubble against the macula.

What if a Macular Hole is Untreated?

A macular hole can lead to continued vision deterioration and significantly impact central vision quality if left untreated. In the early stages, the hole might remain small and not significantly affect vision. However, as the hole progresses, the central blind spot can enlarge, making it increasingly difficult to perform tasks that require detailed vision. Prompt diagnosis and appropriate treatment are essential to prevent or minimise vision loss associated with a macular hole. Regular eye examinations are crucial for detecting any changes in vision and addressing them promptly.