Retina · Retinal surgery
Macular hole
A macular hole is a small opening that forms at the centre of the retina, in the macula, the zone responsible for fine vision. It impairs reading and the perception of detail, and requires surgical management.
Retina · Retinal surgery
A macular hole is a small opening that forms at the centre of the retina, in the macula, the zone responsible for fine vision. It impairs reading and the perception of detail, and requires surgical management.
A macular hole is a small opening that forms through the thickness of the retina, at the macula, the centre of vision. It most often results from traction exerted on the retina by the vitreous, the gel that fills the eye, as it changes with age. Fine vision, used for reading and recognising detail, is consequently impaired.
It affects central vision and causes no pain. Management is surgical.
A macular hole affects central vision, not peripheral vision. Diagnosis rests on precise macular imaging using OCT.
A macular hole is most often related to the natural ageing of the vitreous, which exerts traction on the macula. Several associated factors exist:
Signs relate to central vision:
Diagnosis relies primarily on OCT (optical coherence tomography), a cross-sectional retinal imaging technique, non-contact and painless, which precisely visualises the macula, confirms the hole, and characterises it. This is where Dr Gattoussi's expertise in retinal imaging is particularly valuable.
Treatment of a macular hole is surgical. The procedure aims to relieve traction and promote closure of the hole. [TO BE VALIDATED BY THE PRACTITIONER: exact technique]
Confirmation of the hole and its characteristics.
The vitreous is removed through micro-incisions to access the macula.
A thin membrane is carefully peeled away, then a gas is placed in the eye to promote closure of the hole.
A specific head position may be required in the following days, with close monitoring.
After the procedure, when gas has been placed in the eye, a specific head position may be required for a few days to keep the gas in contact with the macula. Vision remains impaired while the gas is present; it then gradually resorbs. Air travel and certain activities are inadvisable until the gas has disappeared. Precise instructions will be provided.
Recovery depends on the size of the hole, how long it has been present, and the response to surgery. It is assessed on a case-by-case basis, with no guarantee of outcome.
Recovery is gradual, over several weeks, until the gas resorbs and the macula heals.
The gas placed in the eye must remain in contact with the macula: head positioning assists this during healing.
No, while gas is present in the eye. The specific timeframe will be confirmed.
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