What is a Macular Hole?
The board-certified eye doctors at Southeastern Retina Specialists Located in the retina (the layer of light-sensitive tissue in the back of the eye) is the macula, which is in the center of the retina. In some instances, a break can occur in the macula, leading to an assortment of vision problems. Since the macula is responsible for the sharp, central vision that’s required for activities like driving, reading, and seeing minute details, a hole can have a devastating effect on a patient’s vision and overall quality of life. The condition is age-related and commonly occurs in patients over the age of 60.
There are 3 stages of the condition and if treatment isn’t sought in the beginning stages, a patient could risk losing his or her sight.
- Stage I (Foveal Detachment): If untreated, about 50% of these macular holes progress.
- Stage II (Partial-Thickness): These holes are larger than Stage I and about 70% of these untreated holes will progress.
- Stage III (Full-Thickness): These holes can cause debilitating vision issues and most likely will require surgery.
Causes and Symptoms
The eye is naturally filled with a “gel” substance known as vitreous that helps the eye maintain its shape. Inside of the gel is millions of fibers, which attach to the retina’s surface. As a patient ages, the vitreous begins to shrink and pull away from the retina which can cause a tear, or the macular hole. In other cases, fibers continue to be connected to surface of the retina and will contract, which creates tension and can cause the hole to form. Regardless of how the hole forms, the fluid that replaces the vitreous can move through the hole and cause distorted vision and blurred eyesight.
A macular hole can also be the result of a traumatic injury to the eye or could be caused by other medical conditions like retinal detachment.
As the macular hole progresses, there are a number of symptoms to watch out for since the changes can occur gradually. Some of these include:
- Distorted vision
- Blurred vision
- Straight lines and objects having a bent or wavy appearance
- Difficulty reading
- Difficulty driving
- Difficulty with distinguishing fine detail
"He is a very caring Doctor, he will not milk your insurance, he will not give you unnecessary surgery if you don't need it. I will never trust anyone else with my vision"- M.H. / Healthgrades / Aug 17, 2016
"Recently I had an ongoing issue and was passed around to several ophthalmologists via referral. Finally I ended up in Dr. Sullivan's hands. I will say several women I work with had strongly recommended him, and advised me (combined with having been to an ophthalmology appointment 3 times already in a one month span) that I would wait. The receptionist who confirmed my appointment also reminded me "you can expect to be at the appointment up to 4 hours" so it seems my expectations were a little different than some others. When I finally did get to see Doctor Sullivan (an hour and a half or so after my appointment time) he made an extremely scary situation so much better. He has amazing bedside manner and his delivery is understanding. I was really emotional and he assured me he was confident in his diagnosis and resolution. I left the appointment feeling 100 times better & completely happy I ended up in Dr. Sullivan's hands!"- W.T. / Yelp / Jul 19, 2018
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"Goes above and beyond for patients. Very detail oriented. Works well with other Dr if you have multiple eye issues such as glaucoma. There are long wait times in the office but it is well worth it. Dr. Sullivan is the primary Dr at the office but have had to see Dr Agee and he is great too. Highly recommend this office and doctors."- S.V. / Google / May 27, 2018
Treatment and Prognosis
Macular holes will oftentimes heal on their own and require no medical treatment. To repair vision for many patients, surgery is required. The go-to surgery is vitrectomy, where the vitreous gel is removed from the eye to prevent it from continuing to pull away from the retina, as well as to reduce tension. The gel is replaced with an air and gas mixture contained in a bubble. The bubble essentially acts as a bandage to seal the edges of the hole together during the healing process. After surgery, the patient must keep his or head down for a period of 1 – 2 days and sometimes for several weeks to allow the bubble to push against the macula in order to seal the hole.
This surgery can offer many patients a good prognosis where vision can be repaired significantly. However, there’s a high probability of developing a cataract after this type of surgery.
Some patients can benefit from a drug called Jetrea, which can help improve vision with less blurriness and distortion. This FDA-approved medication’s results can vary among patients.
Plan Your Procedure
Treat a Macular Hole
Blurred and distorted vision can be behind you, once you seek treatment for a macular hole. Our knowledgeable and compassionate staff has the tools and expertise to diagnose and treat you. Please contact our friendly staff to schedule an appointment as soon as possible.