The macula is a small, yellowish area about 5 mm in diameter, located in the central part of the retina. It is the most important part of the retina: it allows us to distinguish fine details, perceive colors and movement, recognize faces and read without difficulty.
The remaining 95% of the retina is responsible for peripheral vision.
The retina is a light-sensitive tissue located at the back of the eye. Its function is to transmit light impulses to the brain: it converts images into electrical signals and sends them along the optic nerve, where they are turned into the images we perceive. For vision to develop correctly, the macula is a key piece.
What is a macular hole?
A macular hole is a circular opening that forms in the macula. It is generally caused by aging or as a result of traction from the vitreous, the gel-like body inside the eye. As we age, the vitreous shrinks and separates from the retina. Usually it does so without any problem; however, sometimes the vitreous stays attached to the retina, which causes the macula to stretch and a hole to form.
As the hole grows, a dark spot appears in the central vision and it becomes blurry, wavy or distorted. A macular hole does not affect peripheral vision, but it is a progressive condition divided into 4 stages. Similar symptoms can occur in other conditions of the macula, such as age-related macular degeneration.
A healthy macula is essential for optimal vision. That is why, at the first sign of any loss of vision, however slight it may seem, consult an ophthalmologist or retina specialist, who can diagnose the problem and determine the best treatment according to each person’s characteristics and needs.
Treatment
Treatment consists of a surgery called vitrectomy. During the vitrectomy, the ophthalmologist or retina specialist removes the vitreous that is pulling on the macula and places a gas bubble inside the eye. This bubble helps flatten the macular hole and hold it in place while the eye heals. The gas bubble slowly disappears on its own and is replaced by the fluid the eye produces naturally. This technique is also used for retinal detachment.
Recommendations after surgery
- You may need to keep your face down in a specific position for a certain amount of time, as directed by your surgeon, to keep the gas bubble in place and allow the eye to heal properly. Ask your ophthalmologist about when you can resume your daily activities.
- Your eye may hurt after surgery; you will need to take medication to relieve the pain.
- You will need to wear an eye patch for a certain period of time and apply drops.
- You cannot fly on an airplane, go above certain altitudes or dive until the gas bubble has disappeared, since a sudden increase in altitude can raise the eye pressure.
- If you need to undergo another type of surgery, tell the doctor before the operation that you have a gas bubble in your eye.
- Your vision will improve as the macular hole closes. It may take several months to finish healing. The vision you recover will depend on the size of the hole and how long it was present before surgery.
With current surgical techniques, more than 90% of macular holes are successfully closed.
If you notice a dark spot or distortion in the center of your vision, do not wait. At our clinic in Roatán you can schedule an eye exam to evaluate your macula and protect your vision.