I was diagnosed yesterday with a small macular hole. I am to be evaluated further on Monday in order to determine the stage I am at. The opthamologist indicated it was small during my initial examination. I am scared... I am 52 years old... sounds like the post operative on this is horrible, and a cataract inevitable... can anyone let me now their personal experience with this? I am very concerned about my vision - and the possibility of another one in my right eye..
Thanks
Results of macular hole surgery are generally good especially if your vision only deteriorated in the last few months. You could ask about Jetrea (an injection which is expensive and works in some patients and is licensed in the UK). If you have a cataract now it can be removed at the same time but as you are so young :-) it probably does not apply and so cataract surgery will be done later.
Post operative posturing is a drag as you have to stay face down for days to keep the gas bubble in position (short breaks to visit the loo or have a bite to eat or drink are allowed). Get some nice earphones and download a talking book onto your iphone to keep yourself entertained. Your hospital may loan you a pillow with a hole to make breathing easier or try adapting a memory foam pillow so you can breathe easily. Chances of the same thing occuring in your second eye is very unlikely (under 10%). Good luck.
Thanks for your reply Robert, much appreciated. Can you tell me how long you had in post operative posturing?Also, did your vision go back to normal? I am a financial administrator - use my eyes extensively on a computer 10 - 12 hours per day... I am quite concerned about outcomes. Also, does everyone get a cataract with this surgery?
I am an eye surgeon in Australia and seen many cases like this. The posturing varies. Air lasts too short a time so generally mixed with one of a number of longer acting gases. Hence the length of time the bubble lasts varies but generally several days according to surgeon preference. Every operation carries a risk but if the operation is done within 6 months of symptoms there is a good chance of anatomical closure of the macular hole. Vision can returm to normal 6/6 in some cases, if the retina is otherwise healthy. If you delay for many months you reduce the chance of closure. You need your vision so the decison seems fairly obvious. I cannot advise you as effectively as your surgeon but this type of procedure is well established.
I am wondering if you have used the injectable Jetrea? If so, what were your patient outcomes? I am prepared to pay the price if it is something that I am a candidate for.
Hi Carol. Jetrea is expensive of the order of 3000 pounds stirling and still only works in some cases! I have looked into using it because it offers a deceptively easy answer. It is licensed in the UK but not in Australia where I work. Here there are extra supply chain issues. Australia is huge - the size of Europe from Ireland to Turkey and Jetrea comes from Holland and has to be kept in a super cool deep freeze for the entire journey and distribution otherwise it looses it's effect. Also there have been other adverse issues too making results rather variable. For now surgery is probably overall more effective and cheaper but discuss with your surgeon. And remember if Jetrea does not resolve the problem you would still need surgery.
Thanks Robert... I am in Canada, I think Jetrea is licenced here, but not completely sure.
Thank you for all of your comments on this - it is unsettling when an issue like this comes up suddenly. I still need to be able to work - and when I am dealing with numbers all day - very important that I get my sight back to a working level. When not familiar with this - it seems quite scary! I would also like to think that I could be completely knocked out for the procedure - the thought of someone working on my eye for 90 minutes while I am conscious is horrible indeed.
Thanks again for your comments!
Happy to try to help but I am sure you will discuss all this with your surgeon. Most people having vitrectomy surgery have sedation as well as having the eye numbed. It is not so bad as you fear because the surgeon also needs the patient to be comfortable so they can keep still otherwise it is bad for the surgeon's blood pressure! This is usually easily achieved without recourse to full general anaesthetic (GA).
The worst scenario is when the patient is so sleepy they are disorientated and drifting in and out of sleep and moving to turn over etc. In this situation conversion to full GA anaesthetic helps so it may be worth being starved for 6 hours prior to the surgical procedure.
People with really severe anxiety or claustrophobia may have to have booked GA in the first instance.
Well, apparently I have a 200 micron, full thickness macular hole... now it is off to the retinal surgeon. No signs the end of November. I am hopeful that the surgeon will tell me that this will be an easy fix, and a fast recovery. Trying to get a time line in my head for work purposes, on average would a return to work about week 3 be presumptuous? I am trying to track down some rental equipment that I can use for a few days if I have to face down position - maybe with the size of this (the opthamologist keeps saying it is really small) my face down time will be limited.
I was diagnosed with a full-thickness macular hole on February 2 following signs of macular degenration that started in December. The consultant who discovered the hole said it was important to operate as soon as possible, and I was fortunate enough to get an appointment for surgery on February 12 - menbrane peeling plus the gas bubble.
They kept me in the clinic for five days including the day of the operation. The surgeon - a top man in this field - told me I had to keep the face-down position for two weeks following surgery, and I did. This paid off, and the hole was closed when he examined me again six weeks later.
He also told me the gas bubble would remain in my eye and distort vision for between 6 and 8 weeks, and he was right. The gas bubble remained for seven weeks, and for six of those weeks it was a significant hindrance - for the first three weeks I was practically blind in that eye because the bubble blocked most of the field of vision and distorted the unblocked part.
I would say that you might be able to return to work within three weeks - after the hospitaal and the two-week face-down period - if your other eye is good (unfortunately, my other eye is very weak, so I was unable to work for two months). Apart from the partial blindness in the damaged eye, the other thing that caused me problems was severe lower-back pain from lying on my stomach in bed all night. It was so bad that I couldn't bend or twist my torso and couldn't walk without It hurting badly. It took a week after the face-down period - and daily massage treatment - before I could move normally again.
But despite all the discomfort, I would do it again - the hole has closed, I can read and write again, and the world no longer looks as though it's being reflected through one of those crazy mirrors you (used to) see at funfairs.
I wish you a successful operation and face-down period!
Thank you...I appreciate your comments... Have an appointment with the retinal surgeon on Wednesday, so should be able to get some concrete answers then.
Spoke to retinal surgeon today, hole size slightly smaller than 200 microns, full depth. Surgery, 5 day face down positioning.. What I am wondering is does the distortion go away? I understand that my vision will be reduced from what it was previous to the macular hole, however, I am wondering if anyone out there has had this procedure, and got rid of the distortion??
Thank you!
I had my operation on February 12, and the gas bubble finally disappeared after seven weeks. It's only after the bubble has (almost) gone that you can start to see clearly again, because the bubble creates its own distortions (massive to begin with). Even when the bubble has gone, the eye is still recovering from the operation, so there's still quite a way to go.
I had my eyesight tested on 23 March (6.5 weeks after the operation), and it was good. In the next test on 7 May (12 weeks) it was even better.
The big distortions that I experienced before the operation have now gone, and what is left is a slight distortion, a very small blind spot, at the centre of focus, even though the hole is closed. This spot may eventually disappear because the eye is still healing, my doctor says. No one can predict how long it will take or whether the blind spot will fade entirely or not. But even if it doesn't disappear, I can live and work with it, no problem. I'm very pleased with the result as it is.
Hope for a successful operation and then commit yourself fully to that face-down positioning afterwards, it's vital. As m surgeon said to me, after telling me that the surgery had gone very well: "Now it's up to you!" It was very strenuous, but when it was over, it was wonderful to hear the doctor saying the hole had closed and to know that it had been worthwhile. Here's wishing you similar success!
Thank you Edward for your response... I will be glad when it is finally over and I can begin the healing process.
Hi Carol, I had a macular hole op. 12 years ago. Only option then was to lie face down for three weeks. Four months ago the hole opened and I had to have another op. Options now are gas in the eye, or oil in the eye. With gas you now have to lie face down for about two weeks. If you have oil, you have to have a second op. To remove the oil. I chose to have the oil, and have just had it removed. Given the choice again, I would choose the gas. One lesson on the eyes is much better. Hope this helps
I had a victrectomy for a macular hole 4 months ago. I was put out for 20 minutes beginning of surgery then woke. It wasn't bad I could see the dye being used but didn't feel anything . Did face down for 2 weeks which wasn't as bad as. Thought. I was very diligent and at my 2 wk check up the hole had closed. I did have blurry ness and a small blind spot just under the center which was very annoying . My dr would only say that the gas and my cataract didn't get along and the cataract had to be removed in order for me to see better. Living with a blurry eye for 4 months wasn't easy..especially since I am a jeweler and an artist . I managed to function using my good eye and half my bad one. I just had cataract surgery and the eyesight is much clearer but I still have the small,blind spot . I keep wondering if the surgeon did something wrong and cause it or is it just that the macular never really comes back completely from a hole ....any insight?
Hi, I had the Drug Jetrea for VMT.It worked well,.although
I was told if this had not then I would require the Surgery,.
4 Years ago I suffered a CRVO in the same eye, So it was
always a worry that any procedure could worsen the macular
edema, thankfully my Eye was fine,.Unfortunatly I have just
recently developed Cystoid Macular Edema post -op from
cataract extraction.I am presently using topical drugs to deal
with this,.but may have to have Cortisone Injections in my eye.
if the eye drops fail to work,.
Had macular hole surgery 3yrs ago the hole closed but still a little bit of destortion. have now had cateract surgery on both eyes and have just developed a second macular hole in my left eye surgen told me l have been very unlucky. Am now very worried about my sight as car,nt read or wright very well at mo and am unable to reconise peoples faces have also to go for an Fluorescein Angiogram to see if enything else is going on am so worried. Hope someone can reasure me.
Sorry to hear about your bad luck, Christina - that's a lot of surgery in a short time. But if the operation on the first macular hole went well, leaving only a bit of distortion, you have good reason to be optimistic about the outcome of the second operation. I, too, have some slight distortion after macular hole surgery 15 months ago, but reading ability, writing ability and facial recognition - all of which were very difficult before the operation - are all good and stable now.
So try not to worry, it will only wear you down. Trust in your surgeon to do a good job aain.
All the best,
Edward
So, here I am almost a year after surgery in my left eye for macular hole... I have multiple distortion points in the eye, however I can read with it. Now, I seem to be having a problem with my right eye... could I really be so unlucky as to get another macular hole?? I am hoping that it is a floater? I can read the Amsler Grid - no distortion, however, am scared that I have another hole. Must wait for my appointment for several days to see the Optomotrist... I need some hand holding here...