Macular Hole Surgery and Blurred Central Vision: What Patients Need to Know
Retina Consultants, P.C. is empathetic to the feelings of concern and confusion that may arise when you first notice a blurry spot in the center of your vision. This distortion can make everything from reading to recognizing faces challenging. Our skilled and experienced retina specialists are not only adept at modern treatments, but they also take pride in their use of accurate diagnostic tools. Our teams in Hartford, Cromwell, Farmington, Manchester, and Enfield, Connecticut cannot effectively treat any eye concern if we do not understand it.
A macular hole may be to blame for blurry central vision, and surgery is a common and established treatment for this condition. We’ve answered some of our patients’ frequently asked questions about treating this relatively common cause of central vision loss in older adults. So, you can better understand potential options to restore your sight and prevent further complications.
Why does a macular hole cause central vision problems?
Located at the back of the eye in the center of your retina, the macula is responsible for sharp and straight-ahead vision. This is the type of vision necessary for detailed work, reading, driving, and facial recognition. When the macula sustains a small break or opening in its tissue, this is known as a macular hole. While often discussed in tandem, macular holes are not the same as retinal detachment. They both involve the retina, but there is no separation of the retina from the eye wall with macular holes.
Because of the macula’s function and location, macular holes are associated with a blurring, distortion, or darkening of the central vision. Some patients may notice a blank spot in the center of their vision, or wavy or bent lines. Side vision is typically preserved, so people do not typically lose their vision entirely from macular holes – though small holes can grow larger over time if they are not treated.
How do you diagnose macular holes?
Getting a proper diagnosis is the first step to protecting your eye from further damage. Generally, identifying the source of your vision changes involves a comprehensive eye exam. One of our specialists will take a close look at the retina and macula. Advanced imaging technologies are also used to better understand your needs; for instance, the size, shape, and severity/stage of the macular hole. These characteristics can help our specialists to determine if/when surgery is necessary.
Why is surgery considered?
Surgery is designed to close the hole, allowing the macula to heal. We may recommend it if:
- The hole is full-thickness, or goes through the entire macula
- Central vision has been significantly impaired due to the hole
- The hole is still in its earlier stages (earlier treatment may support better outcomes)
Macular holes tend to slowly enlarge. Many do not close on their own. By treating macular holes, we may prevent more permanent central vision loss.
How is surgery done?
The primary surgical treatment for macular holes is called “vitrectomy.” It involves gently removing the vitreous gel from inside the eye. Our specialists may also lift a thin membrane from the surface of the macula, which can help the hole to close and reduce traction. Due to age-related changes, the jelly-like vitreous can shrink and pull away from the retina. This pulling can produce holes. As part of this surgery, the hole is sealed by filling it with a special gas bubble that gently presses against the macula from the inside.
What can I expect after surgery?
The gas bubble mentioned above also acts like an internal bandage. It is slowly, safely, and naturally absorbed in the days or weeks following surgery. Do not be alarmed if your vision looks very blurry immediately afterward. The bubble can create distortions, such as a water line or a moving black or gray circle in your field of vision. As the bubble diminishes in size and the retina heals, your vision should gradually improve. It is important to follow any and all instructions for care provided by our team, especially as it relates to the gas bubble. For instance, you cannot travel by airplane or travel to high-altitude areas until the gas has fully resolved, because significant pressure changes can be dangerous to your eye health.
How much can my vision improve?
There are several factors that can influence surgical outcomes, including:
- Hole size
- Hole stage
- Length of time the hole has been present
- Eye health, i.e., comorbidities such as diabetic retinopathy
- Surgical and post-surgical complications
Your central vision may slowly become clearer as the macula heals. Be patient. Full recovery can take several months, and results vary from person to person.
Since earlier treatments may be associated with better outcomes, it is important to contact Retina Consultants, P.C. as soon as you notice changes in your central vision. Call one of our five area offices today.
Hartford
Manchester
Cromwell
Farmington
