The retina of the eye is a layer of nerve cells that detects light coming from outside and transmits it to the brain. If we compare the eye to a camera, the retina is the film strip inside the camera.
The macula region is located in the middle of this layer. In the middle of the macula area, there is the fovea region, where the light is focused and approximately the diameter of a pinhead. The fovea region, or “yellow spot” as it is popularly known, is the most important region of the retina layer responsible for central vision and detailed vision.
A macular hole is a puncture that occurs right in the middle of the visual center. In patients who develop a macular hole, a black spot forms in the visual center and affects vision greatly.
Detailed vision functions such as recognizing people’s faces and reading newspapers are greatly affected. Peripheral vision is not affected because other retinal areas are normal.
Although the factors that lead to a macular hole are not fully known, some changes that the eye experiences with age play a role. The intraocular fluid called vitreous contracts over time, applying a pulling force to the visual center and creating a hole in this area.
The most common cause of macular hole is a condition called idiopathic, which occurs spontaneously without any cause. Age has an effect on this.
Apart from this, trauma to the eye can also cause macular hole. If a macular hole occurs spontaneously in one eye, the probability of it occurring in the other eye is higher than in healthy individuals.
Prof. Dr. Tansu Erakgün
Retina Diseases and Vitreoretinal Surgery Specialist
Born on March 20, 1968, in İzmir, Prof. Dr. Tansu Erakgün completed his middle education at Saint Joseph College and his high school education at Karşıyaka Gazi High School. After graduating from Ege University Faculty of Medicine in 1992, which he entered in 1986, he began his residency training in the Department of Ophthalmology at Ege University Faculty of Medicine Hospital in the same year. In 1997, he became a specialist...
About Me VideosHow many stages does a macular hole have?
Macular hole is a potentially dangerous disease and it is necessary to be aware of how many stages macular hole has. A macular hole is an opening in the macula region, which is the center of vision, and can cause vision loss. Macular hole usually occurs with old age and usually affects only one eye. However, over time, it may also occur in the other eye. There are three stages of macular hole:
- First stage: The area where the macular hole occurs is slightly flattened and the symptoms are mild or almost non-existent. At this stage, the macular hole may not be treated, it has a chance to heal on its own.
- Second stage: The macular hole has now formed and symptoms are evident. During this stage, symptoms such as blurred central vision, blurred vision, or seeing dark spots often occur. Treatment is surgery to eliminate symptoms and close the hole. At this stage, the surgery has a very high chance of success.
- Third stage: In this stage, the macular hole has become larger, its connection with the vitreous fluid has been completely broken, causing serious loss of central vision. If left untreated, permanent vision loss occurs.
- Fourth stage: The macular hole has now become very large. It is an indication that a long time has passed. However, there is a chance for treatment.
For macular hole treatment, the ophthalmologist first evaluates the duration, size, location and symptoms of the macular hole. Macular hole surgery is the most common treatment method and its success rate is quite high. During surgery, a thin membrane is peeled off in the area with the macular hole, and if necessary, a tissue patch is placed, which closes the hole and ensures healing. Following the surgery, the patient’s compliance with medical advice and regular check-ups will increase the success rate.
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How is Macular Hole Treated?
The aim of macular hole treatment is to reduce the pressure inside the eye and ensure the closure of the macular hole. One or more of the following methods can be applied in the treatment of macular hole:
- Preventive treatment: This treatment is done to prevent the formation of a macular hole, and medications are usually given to lower the pressure inside the eye.
- Surgery: In the treatment of macular hole, surgery is performed to close the macular hole. For example, a surgery such as parsmayan vitrectomy allows the macular hole to be closed by placing a tampon over the macular hole.
- Laser treatment: In the treatment of macular hole, laser treatment is performed to stabilize the tissues formed around the macular hole.
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How is Macular Hole Vitrectomy Surgery performed in Izmir?
It is not possible to treat the macular hole with medication; surgery called vitrectomy is performed. In vitrectomy surgery, the vitreous fluid is cleaned, the thin membranes in the macula area that cause shrinkage are peeled off, and then an air-like gas is injected into the eye.
After the surgery, the patient’s vision will be poor for a few weeks due to the gas inside the eye. As the gas spontaneously withdraws from the eye and eye fluid replaces it, the patient’s vision improves.
The success rate of the surgery, that is, the probability of closing the macular hole, is around 80-90%. However, this success rate decreases in trauma cases, long-term holes and large diameter holes.
Macular hole surgery can be performed under local or general anesthesia. To increase the chances of closing the macular hole, patients are placed in a face-down position for several days after surgery.
| Processing Time | 1 hour |
| Risks | Intraocular bleeding, hole not closing, retinal tear |
| Side Effects | Cataract development |
| Who Can It Be? | Anyone who develops a macular hole (emergency) |
| Return to Work Time | 1 month |
How Much Are Macular Hole Treatment Prices in Izmir?
You can contact your doctor to get information about Izmir macular hole treatment prices.
F.A.Q.
What happens if the macular hole is not treated?
If the macular hole is not treated, vision may deteriorate further over time and cause vision loss. Therefore, it is important to treat the macular hole. A macular hole is a hole formed in the macula area inside the eye, and this hole may cause loss of vision. “This disease may occur as a result of degeneration or rupture of the macular region within the eye.
How many hours does macular hole surgery take?
Macular hole surgery is a procedure that involves repairing a hole in the macular region of the eye. Macular hole surgery usually takes around an hour and is performed under local or general anesthesia. During macular hole surgery, the ophthalmologist will close the macular hole. “It places the parts to be used inside the eye. These parts help close the macular hole and help repair the macular area within the eye.
Does the macular hole close on its own?
Macular hole usually does not close on its own and needs to be treated with surgery. There is no method to stop the formation of macular hole. If the macular hole is not treated, vision may deteriorate further over time and cause vision loss. Therefore, it is recommended that macular hole treatment be treated with surgery. It is important to do this.
References:
https://www.aao.org/eye-health/diseases/what-is-macular-hole
La Cour, M., & Friis, J. (2002). Macular holes: classification, epidemiology, natural history and treatment. Acta Ophthalmologica Scandinavica, 80(6), 579-587.