Macular Hole

Macula -Focussing Area of the Eye 

The macula is a very small, central area of the retina, a thin layer of light sensitive tissue that lines the back area of the eye and is the focusing surface of the eye. Light rays are focused onto the retina where they get transmitted to the brain and identify the image which is seen. The macula is responsible in pinpointing vision, enabling to see the print while reading, sew or to recognise a person.It helps to see things directly in front as well as helps to see colour and other details.

The macular hole is a small break in the macula, the area which is responsible for details and the central vision of the eye. In the early stage, a macula hole could cause blank spots, blurring or distortion of the central vision. Straight lines may tend to be seen wavy or bowed and one may face discomfort while reading small print.

After some time, the persons may see small black patch or a missing patch in the centre of the vision. As we tend to age, the thick vitreous gel in the centre of the eyes shrinks, pulling always from the macula and the gel sticks to the macula and does not pull back, the macular tissues gets stretched eventually tears and a hole is formed.

The Amsler Grid Test

Macula hole is very common in people who have crossed the age of 60 and above and this condition may differ among individuals and a consultation with the physician is essential if faced with any of these symptoms. The macula often affects only the central vision and the peripheral or side vision is not affected but the person may have some difficulty in reading and with close vision and may notice grey or black spots or even blank area in their vision.

 It usually affects only one eye instead of both the eyes though there could be a possibility of both the eyes getting affected.It may develop over a period of time and one may fail to notice any symptoms till the vision gets affected.The initial stage starts with blurring and distorted images and the straight lines like the window frames, telegraph poles or lines of text may appear wavy or bent. A simple test, the Amsler Grid, will help to determine if the vision is distorted.

Virectomy for removal of the Vitreous Gel 

The location and the size of the macula hole can determine on how much the vision has been affected. There are three stages of this condition wherein the vision will tend to deteriorate as the condition progresses and worsens.

The treatment for macula hole is most effective if it is carried out in its initial stage of development of the condition. Surgery is usually essential to repair the hole and is often successful though one needs to be aware of the possibility of complication of treatment and that the vision may probably not return completely to its normal state. An operation known as vitrectomy is adopted to carefully remove the vitreous gel from the affected eye and replaced with a gas which helps in the healing of the macula hole