Safe, Effective Treatment Options
A macular hole affects your central and reading vision. Macular holes generally develop during the natural aging process, when the vitreous (the gel that fills most of the eye) separates from the retina or, in this case, macula which is the central part of the retina. The vitreous gel can pull on the macula and cause a hole to form. Less commonly, macular holes can also be caused by eye injury, inflammation, retinal detachment and other diseases. Most cases, however occur in women over the age of 50.
At first, a macular hole may only cause a small blurry or distorted area in the center of vision. As the hole grows over several weeks or months, central vision progressively worsens. Your peripheral vision is generally not affected, and there is no risk of complete blindness.
Surgery is over 95% to 98% effective for the treatment of macular holes. The procedure can be done as an outpatient with local anesthesia. Generally, the procedure requires face down positioning for 2 days after surgery.
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A macular pucker or wrinkle or epiretinal membrane is scar tissue that grows over the macula or the area that is responsible for reading and making out fine details in an image. The vision can often be blurry or distorted. In the early stages your reading can be affected as a macular pucker often impairs your contrast sensitivity.
Mild cases generally do not require treatment and usually just warrant observation. In the setting of swelling or macula edema that sometimes develops with a macular pucker topical drops or medication administered into the eye can help improve the vision.
In more severe cases, vitrectomy surgery is required to remove the macular pucker or scar tissue from the retina. The surgery is performed as an outpatient and typically takes 20 to 30 minutes. Unlike macula hole surgery, only a small number of patients require an air or gas bubble to close any holes or breaks in the retina. A small number of patients may have persistent swelling that often requires ongoing treatment with topical drops or intravitreal medications.
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