Central vision loss often results from Age related macular degeneration or alternatively a macular hole—both benefit from prompt specialist evaluation.
A macular hole is a small hole in the central part of the retina which can lead to distortion and blurring of central vision. They can be detected by a scan of the back of the eye.
As a hole gets bigger, patients may notice distortion and blurring of vision. The cause of a macular hole is not always clear, but on some occasions may be related to a shrinkage of the jelly filling the posterior part of the eye (the vitreous) which then pulls on the macula (vitreo-macular traction).
Vitrectomy surgery is the main treatment offered and involves the removal of the vitreous gel from the eye, which is then replaced by a bubble of inert gas allowing the hole to close.
As we get older, the macula (the central part of the retina responsible for detailed vision) can begin to break down, causing blurred vision. The macula allows us to see fine detail for activities such as reading, recognising faces, watching television and driving. It also helps us to see colour.
There are two main types of AMD: dry and wet. The extent of the degeneration may be different in each eye and may not progress at the same rate. It is very important to seek early examination and treatment if there is sudden distortion or reduction in vision. There are now some very effective drugs available which can be injected into the eye to stabilise and in some cases improve vision.
This procedure involves removing the vitreous gel (that has caused the retinal tear) from inside the eye. Then to seal the tear the surgeon uses either laser or a freezing probe to make a scar around the tear. A gas or silicone oil bubble is then inserted into the eye to support the retina while it heals. A gas bubble slowly absorbs over 2 to 8 weeks but a silicone oil bubble will need a small operation to remove it at a later date. Your vision will be very blurred initially due to the presence of the gas or oil bubble.
Most retinal tears are small and can be treated using laser or cryotherapy (freezing procedure). This seals the tear and reduces the risk of a retinal detachment.
Retinal detachment surgery can be performed under local anaesthetic or general anaesthetic. Under local anaesthetic you will be awake but you will not feel any discomfort as the eye will be numbed with an injection. You will not see the operation and the other eye will be covered. If a general anaesthetic is chosen then you will be fully asleep. The decision as to which type of anaesthesia is most suitable will be made following a discussion between you and your surgeon.
If you have been given any posturing instructions then these should be followed. You can bath or shower, but avoid splashing water near the eye. Generally you may do anything with which you are comfortable. Most people choose not to drive over the first few weeks. You must not fly until the gas bubble has gone and you must inform the anaesthetist if you require a general anaesthetic for any operation while there is gas in your eye.
Most retinal tears are small and can be treated using laser or cryotherapy (freezing procedure). This seals the tear and reduces the risk of a retinal detachment.
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