Surgery for the repair of a FTMH is called vitrectomy. I exclusively use the latest generation micro-incisional keyhole surgical equipment to perform this operation. Through just 3 tiny incisions, each only approximately 0.5mm in length, the vitreous gel is delicately removed from the eye allowing access to the FTMH. Using very delicate (eg photo of instruments next to a coin etc?? ) forceps, a very fine retinal membrane which is only 1/400th of a millimetre thick is gently lifted
Although some very early FTMHs can occasionally just be monitored, surgery, which is the only treatment available, is advised for the vast majority of FTMHs and aims to improve your vision by closing the FTMH. It is well established that the chances of closing the FTMH and improving your symptoms of reduced vision and distortion are greater the smaller the FTMH, and
If left alone, there is only up to 1 in 10 chance that a FTMH will spontaneously close with improvement in vision. The vast majority of FTMHs will progress gradually over time to a level where you many not even be able to read the largest print on a standard vision chart. Your peripheral vision will not be affected, however. We know
Macular holes are often visible when your eye is examined by your optometrist or ophthalmologist doctor. Macular holes can also often be seen on photographs of your retina. Macular holes are however best detected and classified with the use of specialist retinal imaging equipment known as an OCT scanner. Your optometrist or ophthalmology doctor may already have performed this for you. This is important in differentiating full-thickness from partial thickness holes, as these
No, they are very different conditions. This is a very important distinction to make as a FTMH is treated by intricate surgery by a vitreoretinal surgeon, where as wet macular degeneration requires simple injections of a drug into the eye.
In the early stages of VMT, many patients will not have symptoms. However, by the time a full-thickness macular hole has developed, most patients will be aware of reduced central vision and distortion when looking at words or people’s faces. Straight lines may also appear crooked, and you may also be aware of a blind spot in the middle of your vision. Occasionally, some patients may
Macular holes affect about 1 in 500 people, and effects women more than men. FTMHs are more common after the age of 60 and in slightly long-sighted and very short-sighted patients. It is not entirely clear why some people develop macular holes and why others don’t. Most FTMHs occur due to excessive pulling on the macula by the vitreous gel (see vitreomacular traction section). FTMHs may also develop due
The eye is essentially a camera, and its camera film is known as the retina, a very specialised structure that senses and processes light. The central part of the retina is known as the macula, which is responsible for detailed central vision including reading and recognising faces. In most people the vitreous gel, which fills most of the
Drops are prescribed to be used for several weeks following the procedure. Additional drops will be prescribed if the pressure in your eye is found to be excessively high at any point.
There may be some discomfort initially which generally becomes less on a day-by-day basis. Simple oral analgesia such as paracetamol for a few days is usually sufficient, if required. It is common to experience mild itching for 1-2 weeks following surgery.