Macular Hole
One of the most serious eyesight problems is a hole in the macula, the central region of the retina.
Macular Hole:
What is Macular Hole?
A macular hole is a defect that affects the central portion of the retina, which is the region of the eye that is responsible for vision. The retina is the most sensitive layer in the eye to light and is similar in function to the film in a camera, which is where the image is created.
There are also instances in which the nerve cells of the macula split apart from one another and disconnect from the surface behind them. This results in a hole being created in the posterior segment of the eye, which can have a variety of effects on the eyes.
Macular Hole Symptoms:
Below we have mentioned some of the many symptoms of macular hole so you can receive the right treatment at the right time:
Decrease in vision
Straight lines appearing curved
No symptoms but detected on a routine examination
Causes of Macular hole
Age related degeneration of the Vitreous (the gel like structure that keeps the eyeball taut)
Injury with fist, ball, shuttlecock, firecracker etc
High Myopia or short-sightedness
Following long standing diabetic maculopathy
Solar eclipse viewing
Who is at risk of developing a macular hole?
Those above the age of 50 and women are more likely to have a macular hole than younger people. To put this another way, the many stages that macular holes go through as they grow can be broken up into portions or sections. Macular hole develops by a progression of four stages (which are graded on OCT scan images). When compared to stages 1 and 2, the vision is significantly impaired in stages 3 and 4.
Types of Macular holes
Macular hole progresses through 4 stages (which are graded on OCT scan images). The vision is poorer in stages 3 and 4 compared to stages 1 and 2.
Diagnosis:
Diagnosis is made by the Ophthalmologist on a clinical examination after dilating the eyes and viewing the retina under magnification with an appropriate lens. Since the hole may sometimes be small/subtle, an optical coherence tomography (OCT) scan is almost always done to confirm the diagnosis as well as to measure the size of the hole, determine its stage and predict the outcome of treatment.
Treatment:
Age-related macular holes of stage 2 and beyond can be successfully treated with vitrectomy surgery. In this procedure, the vitreous gel from inside the eye is removed, the hole opposed, and a gas bubble-filled inside the eye, which self-absorbs in 4-6 week period.
Some surgeons may recommend a face-down position for the initial few days after the surgery to hasten the closure of the hole. Stage 1 holes do not need surgery, but serial check-ups to detect progression to subsequent stages are recommended. If the contralateral eye has developed a macular hole, more frequent check-ups for the normal eye may be advised. Macular holes secondary to other causes carry a poorer prognosis.