The macula is located in the center of the eye’s light-sensitive tissue, the retina. The macula provides the best central vision needed for reading and fine detail. A macular hole is a small tear in the macula caused by the degeneration of the eye fluid, or the vitreous. As aging occurs, the vitreous becomes thicker and forms clumps, pulling away from the retina and potentially leaving a hole.
Blurred and distorted central vision are symptoms of a macular hole. After a careful eye exam to determine the damage of a macular hole, a surgical procedure called a vitrectomy is usually recommended. In a vitrectomy, the vitreous gel is removed and replaced with a bubble of gas or oil to help seal the hole while it heals.
A face-down position must be maintained by the patient after surgery for 1-2 weeks to ensure that the gas bubble stays pressed against the macula to seal the hole and restore vision. The face-down position is essential in recovering vision and there are many devices and approaches that your doctor will discuss with you to make the process go smoothly.
Patients that have had a macular hole for less than six months, have a higher chance of vision recovery from a vitrectomy than those who have had a macular hole for longer. Patients are not permitted to travel by air for several months after surgery, as changes in air pressure may cause the gas bubble to expand and increase pressure in the eye.