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The eye is often compared to a camera. The front of the eye contains a lens that focuses images inside at the back of the eye. This area, called the retina, is covered with special nerve cells that react to light, like film in a camera. These nerve cells are very close together in the middle of the retina where the eye focuses the images that we see. This small part of the retina is called the macula. Sometimes the nerve cells of the macula become separated from each other and pull away from the back surface of the eye forming a hole.


This is called a macular hole. Sometimes macular holes are the result of an injury or a medical condition that affects the eye, including being very near sighted. In most people, it is due to traction on the center of vision that is more likely to occur as we age.


Macular holes often begin gradually. In the early stage of a macular hole, people may notice a slight distortion or blurriness in their straight-ahead vision. Straight lines or objects can begin to look bent or wavy. Reading and performing other routine tasks with the affected eye become difficult.


The surgical procedure for macular holes is performed under local anesthetic so the patient is awake but does not feel the procedure.

The first part of the operation for macular hole treatment is to remove this gel-like material, which is called the vitreous. The procedure to remove it is called vitrectomy.

The surgeon will make small openings in the eye to insert special instruments that are used to remove the vitreous. The surgeon may also remove any small pieces of tissue ("membranes") or traction near the macular hole using fine forceps. This is done to prevent anything from pulling on the macula preventing the hole from closing.

Finally, the fluid in the eye is exchanged with a sterile gas, which keeps pressure on the macular hole until it heals. Patients will need to maintain a face-down position for 1 to 7 days to keep the gas bubble in place and help close the hole.

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