Macular Hole

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I was diagnosed yesterday with a small macular hole.  I am to be evaluated further on Monday in order to determine the stage I am at.  The opthamologist indicated it was small during my initial examination.  I am scared... I am 52 years old... sounds like the post operative on this is horrible, and a cataract inevitable... can anyone let me now their personal experience with this?  I am very concerned about my vision - and the possibility of another one in my right eye..

Thanks

 

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  • Posted

    Results of macular hole surgery are generally good especially if your vision only deteriorated in the last few months. You could ask about Jetrea (an injection which is expensive and works in some patients and is licensed in the UK).  If you have a cataract now it can be removed at the same time but as you are so young :-) it probably does not apply and so cataract surgery will be done later. 

    Post operative posturing is a drag as you have to stay face down for days to keep the gas bubble in position (short breaks to visit the loo or have a bite to eat or drink are allowed).  Get some nice earphones and download a talking book onto your iphone to keep yourself entertained.  Your hospital may loan you a pillow with a hole to make breathing easier or try adapting a memory foam pillow so you can breathe easily. Chances of the same thing occuring in your second eye is very unlikely (under 10%).  Good luck.

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    • Posted

      Hii robert, I’m only 18 and I have iol implantation and silicone oil in my eye. The cause of my retinal detachment was scary tissue but after the removal of that tissue . It has grown again and again I’m having surgery to remove it. I wonder that would it grow again. And my vision is only HM@1ft in that eye would that return to normal
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  • Posted

    Thanks for your reply Robert, much appreciated.  Can you tell me how long you had in post operative posturing?Also, did your vision go back to normal?  I am a financial administrator - use my eyes extensively on a computer 10 - 12 hours per day... I am quite concerned about outcomes.  Also, does everyone get a cataract with this surgery?

     

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    • Posted

      I am an eye surgeon in Australia and seen many cases like this. The posturing varies. Air lasts too short a time so generally mixed with one of a number of longer acting gases. Hence the length of time the bubble lasts varies but generally several days according to surgeon preference. Every operation carries a risk but if the operation is done within 6 months of symptoms there is a good chance of anatomical closure of the macular hole. Vision can returm to normal 6/6 in some cases, if the retina is otherwise healthy.  If you delay for many months you reduce the chance of closure.  You need your vision so the decison seems fairly obvious.  I cannot advise you as effectively as your surgeon but this type of procedure is well established.
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    • Posted

      I had my surgery a month after finding out about my condition. The hole was small I handleed my recovery pretty good, followed but cataract surgery. Till today no one can tell what the cause to this condition beside the fact that it mostly happen to women over 60 and possible trauma to the eye.the only thing that bothers me is, my

      Peripheral vision is 20/20 BUT the center, where the hole was closed have no sight. Maybe scar tissue? If I had to relay on reading with only that eye I can say I can not read. What scares me the most, my Dr says 90% of the time it WILL happen in the other eye. Your thought would be greatly appreciated

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  • Posted

    I am wondering if you have used the injectable Jetrea?  If so, what were your patient outcomes?  I am prepared to pay the price if it is something that I am a candidate for.

     

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  • Posted

    Hi Carol. Jetrea is expensive of the order of 3000 pounds stirling and still only works in some cases! I have looked into using it because it offers a deceptively easy answer.  It is licensed in the UK but not in Australia where I work. Here there are extra supply chain issues. Australia is huge - the size of Europe from Ireland to Turkey and Jetrea comes from Holland and has to be kept in a super cool deep freeze for the entire journey and distribution otherwise it looses it's effect.  Also there have been other adverse issues too making results rather variable.  For now surgery is probably overall more effective and cheaper but discuss with your surgeon.  And remember if Jetrea does not resolve the problem you would still need surgery.
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  • Posted

    Thanks Robert... I am in Canada, I think Jetrea is licenced here, but not completely sure. 

    Thank you for all of your comments on this - it is unsettling when an issue like this comes up suddenly.  I still need to be able to work - and when I am dealing with numbers all day - very important that I get my sight back to a working level.  When not familiar with this - it seems quite scary!  I would also like to think that I could be completely knocked out for the procedure - the thought of someone working on my eye for 90 minutes while I am conscious is horrible indeed.

    Thanks again for your comments!

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    • Posted

      Happy to try to help but I am sure you will discuss all this with your surgeon. Most people having vitrectomy surgery have sedation as well as having the eye numbed. It is not so bad as you fear because the surgeon also needs the patient to be comfortable so they can keep still otherwise it is bad for the surgeon's blood pressure!  This is usually easily achieved without recourse to full general anaesthetic (GA).  

      The worst scenario is when the patient is so sleepy they are disorientated and drifting in and out of sleep and moving to turn over etc.   In this situation conversion to full GA anaesthetic helps so it may be worth being starved for 6 hours prior to the surgical procedure.

      People with really severe anxiety or claustrophobia may have to have booked GA in the first instance.

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    • Posted

      Hi, I had the Drug Jetrea for VMT.It worked well,.although

      I was told if this had not then I would require the Surgery,.

      4 Years ago I suffered a CRVO in the same eye, So it was

      always a worry that any procedure could worsen the macular

      edema, thankfully my Eye was fine,.Unfortunatly I have just

      recently developed Cystoid Macular Edema post -op from

      cataract extraction.I am presently using topical drugs to deal

      with this,.but may have to have Cortisone Injections in my eye.

      if the eye drops fail to work,.

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  • Posted

    Well, apparently I have a 200 micron, full thickness macular hole... now it is off to the retinal surgeon.  No signs the end of November.  I am hopeful that the surgeon will tell me that this will be an easy fix, and a fast recovery.  Trying to get a time line in my head for work purposes, on average would a return to work about week 3 be presumptuous?  I am trying to track down some rental equipment that I can use for a few days if I have to face down position - maybe with the size of this (the opthamologist keeps saying it is really small) my face down time will be limited.
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    • Posted

      I was diagnosed with a full-thickness macular hole on February 2 following signs of macular degenration that started in December. The consultant who discovered the hole said it was important to operate as soon as possible, and I was fortunate enough to get an appointment for surgery on February 12 - menbrane peeling plus the gas bubble.

      They kept me in the clinic for five days including the day of the operation. The surgeon - a top man in this field - told me I had to keep the face-down position for two weeks following surgery, and I did. This paid off, and the hole was closed when he examined me again six weeks later.

      He also told me the gas bubble would remain in my eye and distort vision for between 6 and 8 weeks, and he was right. The gas bubble remained for seven weeks, and for six of those weeks it was a significant hindrance - for the first three weeks I was practically blind in that eye because the bubble blocked most of the field of vision and distorted the unblocked part.  

      I would say that you might be able to return to work within three weeks - after the hospitaal and the two-week face-down period - if your other eye is good (unfortunately, my other eye is very weak, so I was unable to work for two months). Apart from the partial blindness in the damaged eye, the other thing that caused me problems was severe lower-back pain from lying on my stomach in bed all night. It was so bad that I couldn't bend or twist my torso and couldn't walk without It hurting badly. It took a week after the face-down period - and daily massage treatment - before I could move normally again.

      But despite all the discomfort, I would do it again - the hole has closed, I can read and write again, and the world no longer looks as though it's being reflected through one of those crazy mirrors you (used to) see at funfairs.

      I wish you a successful operation and face-down period! 

       

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    • Posted

      Thank you all for your information. My husband had macular hole surgery 3 days ago.  After his first night of sleeping face down he too had horrible back pain which radiated down his leg.  Were you able to take a medication to help alleviate the pain?  Also, had you had back issues prior to the face down positioning? 
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    • Posted

      Hi, Vicki. I've just discovered that "a moderator" has deleted my replies, in which I recommended the only thing that helped me with the back pain I suffered from the face-down positioning. The moderators evidently forbid any mention of any product, even if it is meant to be helpful and relieve suffering. Anyway, let me try again, without mentioning the name of the product: it is a disposable "heat wrap" that you wrap around your waist, and it provides soothing warmth for about 24 hours. You buy them in packs. For me, they were wonderful, and my brother and a freind also tried them and were very pleased with the results.     

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