Macular hole surgery: A journal

[A follow-up appeared on February 3, 2014:  “Macular-hole surgery revisited”]


June 1, Wednesday:  It’s 10:30, a cloudy, warm morning in Phoenix.  Just two hours before I check in for out-patient surgery on a macular hole in my right eye at Barnet Dulaney Perkins Eye Center.  I have mixed feelings.  On one hand I’m eager to get it done, eager to put all these eye surgeries in the rearview mirror.  A cataract was removed from the right eye on April 21 and from the left on May 5. On the other hand, I dread the recovery period from this operation, called a vitrectomy.  Successful recovery depends on keeping my head down for four to five days.  A gas bubble will be inserted into my eye, putting pressure on the hole to reattach itself to the macula and close.  Gas rises, the hole is in the back of the retina.  Therefore the face-down.  Also there is a string of membrane and scar tissue that has broken away and must be peeled off.  All of this has led to a slight distortion of vision in the eye.  A wrinkle appears at the center of everything I look at.  Chances are the eye won’t heal on its own, only get worse.  The optometrist who last looked at the eye said, “You’re going to have very good results.”  I’m hungry but I can’t eat or drink until after the surgery.  Maybe that’s why my stomach is slightly upset.  We’ll see how it goes. . . .   11:05 p.m.  It’s 9 hours after surgery, and I’m trying with difficulty to type on my laptop, head-down in the head well of a rented massage chair.  The chair costs $15 a day.  I took the weekly rate of $75. I’m comfortable for only an hour or so, then must get in bed to stretch out my cramped legs.  The operation went “great” according to the surgeon, Dr. Suhail Alam, a short and cocky dark-skinned man in his 30s.  I entered the operating room at 1:15 and was rolled out 30 minutes later.  Since there were some preliminaries, I figure the actual surgery took 15-20 minutes.  I was awake the whole time, only the right side of my face anesthetized.  Again, like the cataract surgeries, no pain, no discomfort.   A bandage covers my right eye.  I can’t see much, of course, but  I do notice changes in the brightness of light.   Dr. Alam said I must do the “face down” technique for four days but I can sleep on my left side if I choose.  I feel a wetness on the bandage like my eye is watering.  I had a mild headache which might be due to a caffeine withdrawal.  I’ll know more tomorrow morning after the first post-op appointment.

June 2, Thursday:  Day 1 after surgery.  Kept 9:50 appointment at the Eye Center with the optometrist, Dr. Pinkert, 19 hours after surgery.  Bandage was peeled off and eye tests made.  Right-eye vision is poor, very foggy and distorted, due to the gas bubble.  All I can see of the eye chart is its shape and black smears where the letters are supposed to be.   Like a drab Jackson Pollock painting.  The gas bubble is SF6, or sulphur hexafluoride, and is slowly absorbed into the bloodstream.  Like day to night, my left eye tests out at  20/15, continuing to improve after cataract surgery nearly a month ago.   The right eye is progressing normally, Pinkert says.  Must keep head down for four days, meaning until Monday the 6th.  Head down is defined as 50 minutes of every hour.  Or 20 hours a day.  Four days seems a short period from what I’d read on the Internet where three weeks is not unusual.  But Pinkert said, “I’ve been working with retina surgeons for 15 years, and I’ve never heard of more than five days.”  He said the gas bubble should go away by Week 3 and my vision return to normal in three months.  I have one more exam scheduled, in two weeks.  I’m back in the eye-drop mode.  Three drops each day of Vigamox (infection) and Durezol (steroid healer).  On the way home I buy an eye patch at Walgreen’s ala Johnny Depp.  It’s only $2.79 and will allow me to keep the right eye open without distorting my overall vision.  I inspect the right  eye closer at home.  I have a lot of bruising below the eye due to the anesthesia, I’m told.  The skin at the outside of the eye is badly wrinkled.  Still I’m able to recognize the beat-up face in the mirror as my own. . . .  Before bed, I can now see colors better, though everything is still foggy and distorted.  There is now a bit of a jiggle to the gas bubble.

June 3, Friday:   Day 2 after surgery.  Awoke this morning to see even more of a jiggle to the gas bubble.  Turn my head left and right and the bubble keeps moving after I stop.  I pass the time napping, reading a book, playing Words With Friends on Nebra’s Ipad and watching TV, keeping my head down as much as possible.  I watched the Diamondbacks’ game tonight by setting the small TV in the study on end and bringing the massage chair close enough to look straight down.  In the evening I went for a short walk through the neighborhood, training my eyes on the sidewalk below me and holding on to Nebra’s arm.  All in all a boring day.  While the surgery takes great skill, the recovery head-down technique seems primitive.  And there is nothing to tell you if your’e doing it correctly.  In three weeks I’ll walk in to the Eye Center and discover if the macular hole is closed.  If not I suppose that means another operation, this one totally on my money with no help from insurance.

June 4, Saturday:  Day 3 after surgery.  Right-eye vision still poor.  It’s like what you’d see swimming at the bottom of a pool.  Watery and unclear due to the gas bubble.  I can see the green plastic warning band on my right wrist but of course no detail.  The wristband offers instructions in case, say, I was in a car accident.  “Warning: Gas bubble in eye,” it says.   The fine print goes on to say I should not be administered nitrous oxide or be moved to a higher elevation without consulting my physician.   Both would casue the gas to expand with the potential to blow out the eye.  Blindness is not high on my wish list.  Dr. Alam’s name and phone number appear on the underside of the band.  I think the elevtion limit is 4,000 feet.  I asked Dr. Pinkert the other day what retina patients do in high places like the mountainous city of Flagstaff two hours to the north.   Barnet Dulaney Perkins has an eye center there at almost 7,000 feet.  Pinkert said those patients either travel down to Phoenix (el 1,117) or have oil put in the eye rather than gas.  The problem with oil, he said, is that it requires two operations.  One to put it in, one to take it out. . . . This was the worst day for keeping my head down.  Not to say it was a bad day.  I get restless or cramped sitting still.  So I walk around the house, water the plants in the driveway, usually with my head down.  We went out to eat at a Mexican restaurant in the evening, head down most of the time.  But I wonder if the gas is jiggly when I move will it press on the macular hole long enough to help it close?

June 5, Sunday:   Day 4 after surgery.  Last day of face-down spent in reading a book and the newspapers, playing Words With Friends again on Nebra’s iPad, fixing snacks, watering plants in the driveway and watching sports on TV.   Didn’t nap, wasn’t sleepy.   It is easy to begin to believe the gas bubble in my right eye is important.  It is the most visible aspect of recovery.   Like today, the bubble jiggles more than ever and I can see a “water line” forming toward the top of the eye.  The outside world is still so distorted I could not function with the right eye alone.  But in truth the bubble is a sideshow, a distraction to the really important stuff going on behind the scenes.  That’s the closing of the macular hole deep in the retina.  The bubble’s shape, size or length of duration has nothing to do with that.  The bubble will go away one of these days and so what?   It does not indicate success or failure.   It is just a tool.  The surgeon, Dr. Alam, says the success rate is 90 percent, but I will not know the outcome until final tests are made on the 15th, still 10 long days away.

June 6, Monday:  Day 5 after surgery.  The head-down period is over.  Awoke after a good night’s sleep, feeling rested as I have every night since the June 1 surgery.  I’d found a comfortable sleeping method at the end of the bed, lying on my stomach with my head bolstered by two pillows atop a trunk, my nose wedged in between the trunk and bed so I could breathe easily.  I returned to most of my usual activities.  Driving, walking 10,000 steps (roughly 5 miles) and reading upright for a change.  For lunch I warily drove  the busy I-17 out to Old Country buffet with the black patch over my healing right eye.  I found the middle lane and stayed there, not hitting over 55 mph.  There is a definite line in my vision now from the gas bubble.  I called it the “water line” yesterday.  In the small growing space above the line, there is more light and I see the world clearly.  I call it the future.   The larger receding bottom part, or the bubble,  is darker, distorted.  That part, I hope,  is the past.  The shiner is nearly gone.  Just some bruising left around the nose. The wrinkly skin at the edge of the eye is diminished, all but gone.  I’m feeling upbeat again.

June 7, Tuesday:  Day 6 after surgery.  The jiggly gas bubble dissipates fast.  The bubble covered about 5/8 of my right-eye vision this morning and now at bedtime it is 1/2 or less.  Still a top layer and a bottom.  And a distinct line between them.   If I were to use only the right eye, I would stumble over everything.  Returned the massage chair in mid-afternoon to Bare Paws Massage Co.  The firm operates out of a house on the east side.  I’ll miss that chair in a way I can not explain.  I spent a good part of four days with my head sunk down into it.

June 8, Wednesday:  One week after surgery.  The bobbying gas bubble continues to diminish and now takes up less than half of the right eye’s vision.  The clearer part above the bubble is mildly streaked, just enough to distort reading letters on the spine of a book.  I think the streaks come from the gas bubble reflecting light.   Recovery seems to be going well.  Only a few minor headaches and I can not attribute them to the surgery with certainty.

June 9, Thursday:  8th day after surgery.  The good thing is that I’m now down to two eye drops a day.  It was six.  I take the Durezol only, a drop in early afternoon and another before bed.  No more Vigamox.  It’s more difficult to do the eye drops after mac hole surgery than the cataract.  I’ve virtually splashed the drops all over my face because of the blurred vision.  The eye patch’s elastic band is wearing out.  I tied a knot in it tonight.  That helped.  I may not need the patch much longer.  The gas bubble fills about 3/8 of my right eye, maybe even closer to a quarter.  It’s hard to be precise.  The worrisome thing is that I still see a “wrinkle” in the middle of a word or a wave in a straight line with the good portion of the eye.  Has the hole not closed?  If not, will it seal later?  Questions, I guess, for the next appointment on the 15th.

June 11, Saturday:  Day 10 after surgery.  The annoying gas bubble changed shape.  Up until this morning, it appeared as a line across my vision.  Now it is a circle, a true bubble like the ones you see on a carpenter’s level.

June 12, Sunday:   Day 11 after surgery.  The dark oval bubble has gotten smaller.  It covers about 1/10 of the right eye’s vision with my head erect, resting at the bottom.  But if I bend the head over, the bubble centers itself in the eye’s middle and seems to expand.  I prefer reading now using both eyes and have more or less discarded the eye patch.  My vision is far from perfect but improving.

June 15, Wednesday:  14 days after surgery.  Kept my 3-week post-op appointment this morning with the surgeon, Dr. Alam.  All good news, the operation was successful.  The macular hole is gone, he said, after looking at test results: “Everything’s terrific.”  I was relieved to hear the slight “wrinkle” that distorts objects in the center of the right eye’s vision will improve.  “You’re still in the early stages of recovery,” Alam said.   The next, and probably last exam, is scheduled now for September 21, three months away.  By then I should have a definite idea of what my vision will be.  The left eye tested out at 20/15 again for distance and 20/25 for close-up.  The right eye is 20/40 for both.  As for the gas bubble it’s almost gone, covering only about 5% of my vision as I look straight ahead.  It is dark with a big black ring and a round, clear center.  Another day or two and it should disappear.  A very good day all in all.

June 16, Thursday:  Day 15 after surgery.  For the record, the gas bubble disappeared completely about 11:30 a.m.  I was on the treadmill at the gym and suddenly noticed its absence.  This morning when I awoke the bubble was tiny, not quite the black dot I had read about but close.  So bubble gone in 15 days.   The gas bubble is such a dominant aspect of mac hole surgery that you can lose track of what’s really important.  The target is closing the hole.  It is not the bubble nor is it even better vision.  In fact before surgery I signed a disclaimer saying I acknowledge my vision may not improve and may even get worse.   That’s why I wrote yesterday the surgery was successful even though my right eye vision is not very good.  If the hole does not close as mine did, then there is the chance it will get larger — often very quickly — and you can lose ALL vision in the eye.  So I say to myself macular-hole surgery is all about the hole, the hole, the hole.    Better vision is a bonus.

June 20, Monday:  I passed the Arizona eye exam this afternoon and had the daytime-only restriction removed from my driver’s license after five months.   The right eye did not pass muster at 20/40 on the eye chart, but my left eye and overall vision did.  “You’re allowed to fail on one,” said the woman who gave the test.  This was my goal from Day One.  To regain the independence of driving at night again.  Hip, hip . . . .

July 14, Thursday:  The “wrinkle” in my right eye is not improving much.  I’m well along into my recovery, and I’m beginning to think this is it, that it’s not going to get better by my last post-op visit in two months.  I will say the distortion is smaller than before the surgery.  I’m looking now through my right eye at an Obama poster on the wall six feet away.  I can easily read the big print, “Be The Change,” which has 1 3/4-inch letters.   But “inauguration” with letters an inch smaller is distorted so badly I can’t read it.  Praise the gods for my strong left eye.  It makes everything readable and clear.  It seems the right eye does not affect my overall vision at all.

September 21, Wednesday:  I had my 3-month checkup this morning with Dr. Alam.  “As far as I’m concerned, the hole is closed,” he said after viewing the latest laser scan.  He went on to say, the chances of having a hole in the other eye, the left one, is remote.  Excellent news in all but I still have the impairment in the right eye.  While the distortion is less than it was, the wrinkle has not gone completely away.  I can now make out a word, say, though the middle letters are twisted out of shape.  Dr. Alam reiterated that I would always know where the hole had been.  “It’s like a broken bone,” he said, “you always know where the break occurred.  It (my vision) may continue to improve.”  The left eye tested out 20/40.  The right was far superior at 20/20, and I was able to read a few letters on  the 20/15 line.  Using both eyes, I’m still very close to 20/20.  I can read a newspaper and a book without aid, though low-power glasses make it easier.  I hope this is the end of the eye problems, though Dr. Alam wants to see me again in a year.


271 thoughts on “Macular hole surgery: A journal

  1. Just to say I loved your journal. I’m on day 4 after mac surgery and am worried that I haven’t been keeping my head down enough and that the hole won’t close. You seem to have kept a sensible attitude to posturing. So many on the Internet have their heads down 24/7 for 3 or 6 weeks. It makes me depressed. I have to keep it down for a week until I see the surgeon next Monday.

    • Thanks, Josie, and good luck. The variance in face-down time is perplexing. I’ve read testimonials saying patients were told to keep heads down only two days. That’s half as long as I did. A 3-6 week period seems unreasonable. My bubble of sulphur-hexafluoride gas disappeared after 15 days. If the purpose of keeping your head down is to allow the bubble to rise and put pressure against the mac hole to close, why would anyone need to keep their head down longer than two weeks? After the bubble is gone? I’m guessing some surgeons use another kind of gas, one that is absorbed into the bloodstream more slowly.

      • Well i went back for my check up yesterday and i do have the start of a cataract,but it is not yet affecting my eyesight so i have to go back in 6 months time.
        The doctor said everything was fine and that the hole had completely closed.
        I believe they only started doing surgery to fix macular holed in 1991,so i feel really lucky that some thing could be done about it.
        I hope all goes well for you when you have your final check up.

    • I enjoyed reading your blog. It is 9 months since I had a vitrectomy to repair a macular hole.
      I dont know how long i had it before i noticed. Just by chance one day I happened to be looking out of the window while rubbing my good eye and I noticed the lamppost was distorted. Yet when i looked with both eyes it was normal. I was told that it was a large hole.

      Thankfully the surgery was successful in closing the hole. I still have a very small blurry patch but thankfully no distortion. I am having a check up next week to see if I have developed a cataract. I have not noticed any symptoms.

      • I’ve read that cataracts often form after a vitrectomy. Unlike you, I had cataract surgeries on both eyes BEFORE the vitrectomy. In fact it was during the pre-op exams for cataracts that the macular hole was discovered. Cataract surgery is relatively safe and can produce astounding results. I hope you’ll write back after your check-up, Cathy. As for my macular hole, I’m going back for a “final” check-up on September 21 and will describe the outcome.

    • I just had my surgery..8 days post op I was told the hole was closed and to return in three weeks for another checkup..I was 8 days and nights facedown 24/7 except to eat and use the bathroom..I’m getting vision back slowly and I’m very pleased..

  2. It was 3 weeks before the surgeon said my mac hole was closed. You seem to be on a good course. But I’m curious. What was your vision like before surgery? Did you have a “wrinkle” say in the center of a line of words? If not, how was the hole discovered? What kind of gas was used? There seems no standard procedure with this kind of surgery, which amazes me in a way. Again, continued good luck, Josie.

  3. Before surgery I was really only using my left eye which has good sight. Through the other eye the world was very weird with wavy lines, swirls and disappearing objects! I had cataract operation 2 years ago when my right eye became very cloudy. I’d always had very different vision in my right eye from my left. When I discovered contacts in my 20’s I thought I had solved all problems and wore them all the time for the next 12 years. Unfortunately I then got a corneal ulcer followed not long after by iritis which reoccurred over the next few years. This was helped by steroid drops which unfortunately caused the cataract. We don’t realise until too late that eyes are precious! Anyway

  4. My iPad completely seized up so had to press send. My optician realised I had a problem when lots of letters on the eye chart disappeared. He sent me to the hospital where they diagnosed a macular hole. I’d never heard of one before so was very grateful to find information on the web. I had no idea what type of gas they were putting in my eye. You tend not to ask when it is on the NHS. I did ask him on monday though and he said they had put in a long lasting gas because they had wanted to take care of my eye. They had found an old retina tear and done some laser work to stop it detaching. My op was over 2 hours and he said the eye had looked very good when they finished. Reading a website from Florida today I notice they say that if they put the long lasting gas into the eye you don’t have to worry about positioning so much but that the sight is not going to start coming back until a month after. I just glad they can treat a mac hole now. 20 years ago they had only just started the operations for it.

  5. Thanks for writing this blog. I’m on day 6 of recovery from retinal detachment surgery. Your accont is the most detailed I’ve been able to find.

  6. I appreciate your journal. I had my macular hole surgery Nov. 2, 2011. I did the face down therapy for 9 days. How miserable! My gas bubble dissapated Nov. 13th. My eye was really black and purple. Today is Nov. 28th, my eyesight is the same as it was prior surgery. I still see wavy lines and a light grey spot in the center of my vision. I hope some of my sight comes back. I have a follow up appt. Dec. 12th. I’m 63 yr. old female, have not been to an eye doctor in 23 yrs. Luck have it, my husband and I took the grandkids to a county fair near us, we visited a Lions Club free vision and glaucoma screening. I could only read the two EE on the chart, nothing below it. My right eye was bad. My husband had not been to an eye doc for 15 yrs. and they said he has glaucoma. Our eyesights are a blessing. We will take better care of ourselves. I really appreciate you’re day by day journal. It helped me a lot. Thank you!

  7. I have had detached retina, macular hole in right eye. The face down for 7 days was the pits. Thankfully, I just had macular pucker surgery (other eye) here in Calif. and this doctor said he does not believe the face down position is necessary at any time. I was so relieved. He has given many lectures, written many articles based on studies with findings the face down position does not improve the outcome.

  8. Yes, his name is Paul Tornambe. You can google him and see all his publications on this. His offices are at Scripps [in LaJolla, CA] and Poway.

    • Thanks again, Marilyn. Dr. Tornambe is a 65-year-old opthamologist with offices in the San Diego area. His website says he first published a paper in Retina magazine in the mid-1990s, advocating no face-down and cataract surgery before or at the time of mac-hole repair. The origins of face-down, Tornambe says, was to prevent the gas bubble from touching the eye’s natural lens and causing and immediate cataract. But since the gas bubble does not affect the plastic lens after cataract surgery, there is no need for face down. He lists other doctors by state who don’t follow the face down procedure.

  9. First day sitting up after five days with my head down. The account of what you have experienced mirrors mine almost exactly and is reassuring. My recovery seems to be going well. Before surgery I read all the medical info I could find but it’s nice to read a first hand account from someone who has been through it. Best wishes, and here’s to life beyond the hole…

  10. I had macular hole surgery on 10-10-12 and am on my last day of face down. My Dr. recommended 8 days. It has been a long week and I can’t imagine doing this for 2 weeks. I have no idea what type of gas was used. After 7 days I still see nothing. How long we’re you off work and how long before you could drive? I can work from home if I have to so am hoping Dr. will okay this at my 2 week checkup 10-29.

  11. My gas bubble (SF6, or hexachloride) disappeared on the 15th day after surgery. I could’ve driven and gone to work on Day 5 immediately after my four days of face-down. I had 20/20 out of the other eye, so no problem, particularly if I wore an eye patch. You wrote “I still can’t see” and wonder whether you’re speaking of one eye or both. Hope you’ll write back after your checkup on the 29th.

  12. I really enjoyed the realistic journal of your ‘macular hole journey’. I am day 12 after my vitrectomy for a large (500 micron) hole of undetermined duration. 40 minute operation with local freezing was done and a SF6 gas bubble inserted. No pain or bruising during or after operation. 3 day face down positioning which I managed with a little bit of creativity rather than with rental equiptment. I felt comfortable driving after my face down period was over. Was checked on Day 9 post op and the doctor said that the hole was apparently closed, though I will return on Day 16 for an OCT scan to confirm. Vision in my eye is still very distorted, but the doctor said it was early and it might take 4-6 months before we know how much vision will be restored. Apparently the eye must ‘relearn’ to see in this new landscape. Am hoping for the best.

  13. Thanks so much for your comprehensive journal. I am facing the same surgery and feeling a bit anxious. It always helps to know what to expect and it takes the fear factor down several notches.

    • Connie, here’s wishing you the best. If you come back this way, I hope you’ll describe your surgery’s outcome and how many days of “face-down” your doctor required.

  14. I had Mac hole surgery two weeks ago, Feb 4. The procedure went flawlessly, but I was unable to go home due to an altitude issue. Due to the gas bubble, a great change in altitude can create dangerously high intra-ocular pressure, and can lead to loss of sight. So I had to spend the first week of recovery in a motel.

    Everything I read beforehand stressed the importance of maintaining the initial face down period, so I raised my head only to instill drops in my eye. I spent the week staring down when I walked and using various pads and cushions so I could maintain the face down positioning. A mirror allowed me to watch TV (backwards), and I stood to use my laptop flipped back so the screen faced upward.

    At my one week checkup my progress was described as excellent. My ocular pressure was perfect, and the Dr cleared me to travel home. Had an easy trip home, no discomfort aside from keeping my face pointed at the floor for two hours.

    But the Dr told me to remain face down for an additional two weeks!
    It was first explained to me that the bubble was meant to serve as a sort of bandage to keep the repaired tissues in place. I’ve read many accounts of vitrectomy recovery and almost all said their Dr recommended five to fourteen days face down, so three weeks sounded excessive. But I stuck it out. Until today.

    Now the bubble has dissipated rapidly, and is surely too small to have any effectiveness as a bandage. So I raised my head this morning, and so far no problems. I still have a great deal of distortion in my vision, but little blurriness, and I’ve had no pain at all except related to positioning. The bubble is annoying but certainly no problem. Until it is totally gone though, I will avoid facing straight up except when using the drops, as I’ve read that the bubble shouldn’t contact the lens of the eye more than absolutely necessary.

    I may have to live with the distortion, but I should still have good peripheral vision. Without the surgery I would probably lose all vision in the eye. If anyone is debating whether to have the surgery or not, the procedure is a piece of cake, and the recovery process is actually not as tough as it sounds. It’s well worth it to save the vision you have.

    • I’ve had both macular hole and pucker surgery.  My doctor in Poway, CA, does not subscribe to being in the face down [after] surgery, and he gives lectures all over the country about this.  He told me it’s only to prevent cataracts.  My bubble dissolved so fast that the face down position by day 6 would have been moot.  Vision after macular pucker did not completely come back…still wavy but understand there was a good chance for that. (EDITOR: Here is a website explaining the difference between a hole and a pucker. )

    • BBB

      My wife had the mac. hole surgery on 23rd Feb,2016 (4 weeks ago). Last Doctor check up was done on 12th March, and he has given us permission to fly to visit our son in Atlanta. In your case the Doctor cleared you for air travel one week after operation. This information is giving us the confidence to take the air travel after 6 weeks of surgery. Hope there will be no problem.


  15. Thanks to all for your many insightful stories and comments. I am at day 7 after macular hole surgery and the vision capabilities described in the majority of your stories parallel my experience as well. However, my post-surgery swelling was hugely more severe – including my eye leaking blood for two days after surgery. My entire eye and eye structure was swollen and sensitive – I looked much worse than Rocky did after fighting Apollo Creed! It was miserable. Plus, my face-down tolerance must be less than average because I was going insane after just three days of having to look down all the time. My neck and back, shoulders and elbows were all really sore. And the doctor told me not to exercise or be “active” at all in any way. “Calm.” he kept telling me. Then the doctor told me to look down another five days…OMG! I couldn’t do it…and the size of the bubble now is far too small for any face-down postioning to be effective. I wish you all luck and prayers in your healing.

  16. Hello everybody, I’m having vitrectomy done next month in Italy. For the moment I’m just worried about the operation. Is it painful, does it last lomg? Help!

    • if it’s like mine, you will feel NO pain before or after, not even discomfort. the surgery lasted 15-20 minutes, and i talked with the surgeon as he went about his work.

  17. Thank you, everyone for relating your experience on macular hole repair. I am scheduled for both cataract surgery and vitrectomy on my right eye in a few weeks. I am in Canada and my doctor is one who does not prescribe ‘face down posturing’. Because he is performing the cataract surgery first and implanting an IOL (intraocular lens) and inserting a larger gas bubble the only restriction is to sleep on my left side (not on my back or right side). If anyone else has had experience with this method I would appreciate hearing from you. Needless to say I am nervous about the surgeries and feel the need for reassurance.

  18. loved reading your journal..I’m facing surgery on Thursday Oct. 10, doc says the hole is a small one, and I noticed it about 3 weeks ago..had some trouble reading..the words at the ends of the lines were distorted..I kept looking for brighter lights…I’m told that face down would be necessary for one week..let’s hope..wish me luck.

  19. Remember, madelyn, surgery will close the hole but it may not clear up the distortion. The surgery’s “scar tissue” will remain to some extent. And, as my physician said, “You’ll always know where the hole was.” Today, 2 1/2 years after my surgery, a line of type, say, will still have a “ripple” in the middle, if I use only my right eye. Fortunately I have 20/20 vision in the left one, and when I read using both eyes, the vision is normal with no or very little distortion. The surgery is meant to save the eye from potential total loss. Macular-hole surgery is a highly-successful procedure, and I hope, and believe, you will have a good outcome.

    • had the surgery and it went well..I was 24/7 facedown for 8 days and last Friday (the 18th) was told that the hole was closed, confirmed by OCT..sleeping now on left and right side and my head is up and I’m feeling much better..I was at a very low point after a few days next appointment is Nov 8th (three weeks) and the bubble is almost far so good..thanks again for the support and great helped a great deal

  20. I wrote about upcoming surgery on July 20. I had my cataract and vitrectomy surgery on Sept 18 and I am now at week 3 in my recovery. The only issue I have had is a constant headache over and under my right eye. I am able to see with my right eye only with the sensation of being under water, I am able to see outlines and shapes, but nothing clearer than that. The large bubble that was inserted has reduced to about 1/4. I was instructed to sleep in a sitting position at a 60 degree angle which I have done faithfully. Very uncomfortable for someone who has always slept on my side. I will have a 3rd post operative appointment on Oct 8 and am hoping to hear that my eye is still healing well.

  21. Best journal I have read on macular hole vitrectomy. I had one done October 2nd. I had to do the face down positioning for five days 90% then four hours a day for the next two days. My bubble still seems very large but I am starting to see the line at the top and catching glimpses of things up there. Below the line I can only see shadows and light. I don’t know how long I have had the hole. Could have been years now that I look back at things that had happened. Thankfully the last optometrist I saw noticed that I was not seeing as well with my right eye as I did with my left and suggested seeing an ophthalmologist. At first we were going to try a new injection “jetrea” but the hole became worse while waiting to see if insurance would cover it so it was on to the vitrectomy. I return to the doctor on October 28th and will pray he will pronounce the hole closed. I purchased a massage table and chair on Amazon and with applying for their credit card was able to get both shipped to me for $170. Cheaper than renting and I can resell them. Also I was able to have them well before the surgery so I could have everything set up just right. Longrow’s account is very similar to mine and felt reassuring to read it. Thanks for writing it.

  22. I had my 3rd post-op appointment on Oct 8 and my doctor says he is very happy with the result. The hole is closed, but he did say he found some small scarring on the retina so performed minor laser therapy (about 10 seconds worth). Prior to the appointment I was beginning to see more clearly than the watery view I had after the surgery, however, since the laser therapy I can see very little with my right eye. I can see light shapes, but nothing is clear and I even have trouble seeing the bubble now. I am seeing him again on the 17th, so I am hoping he will explain what is happening. I have been suffering mean headaches, mainly because I have been keeping my right eye closed and straining the muscles in my eye. It’s easier to read and watch television with the eye closed. I have been driving since about 10 days after the surgery and have no problem driving with my eye open then, (probably something to do with peripheral vision). I am feeling anxious about the worsened vision after the laser, when it was clearing so nicely before. I will keep in touch and let you know what he says on the 17th. Thanks for the opportunity to participate in this blog, it was a great help to me prior to the surgery, and if my story helps anyone else, them I am happy.

  23. I am on day 13. My bubble seems to be taking its time to dissipate. It now is a line in my vision that if I look down I can see what is above the line in my peripheral vision but if I focus straight on or up everything is back to very blurry. What is strange is that I wear bifocals and when I look down at something held very close to my eyes without my glasses I can see it perfectly through the gas bubble albeit a little watery looking :). My pupil is still just about dilated the same as it was six days ago when I discontinued the atropine drops. Good thing is I finally have no aches or pains and my face and eye area is looking back to normal besides the pupil. My depth perception is not so good. When I try to grab or touch something i miss by three inches or so. Floaters are getting less. Two more weeks before my next doctor visit. Seems like forever. I am getting anxious to find out whether the hole is closed.

    • My bubble disappeared last evening after getting smaller and smaller yesterday until it was a little black dot..sleeping well on both sides. Vision still blurry in right eye and I do need to get new glasses since I had the cataract removed exactly two weeks before the vitrectomy rather than having it done at the time of surgery or down the road. I’m sure it will get better over time, but I’m going to take a short drive locally and get some confidence back. I’m definitely on the mend and will see the surgeon on Nov 8th. I feel that the worst is behind me!

      • I am jealous Madelyn. My bubble friend is still hanging around three weeks post op. It was getting smaller day by day last week but seems to have slowed down this week. Getting tired of the depth perception looking through the bubble when I look down. I did have a stage 4 hole so maybe I had a large bubble inserted. My vision has changed in the eye as far as the hole so I am hoping this is a good sign. Before surgery I got more of a scrunched vertical disturbance and now is more of a small grey circle. Getting lots of little black things flying around above my bit of bubble. If I look down I can see the whole bubble and head up I see the top part of it at the bottom of my vision although I know the bubble is going up. I also get light rays reflecting off the rim of the bubble when I look at tv or window or something that emits light. Looking forward to my appt on Monday.

  24. Saw my surgeon today…. what a mess! He tells me the scarring that he supposedly corrected last week with laser has spread and has detached my retina. I now have to have more surgery on Monday to insert ‘oil’ into my eye. I am so frustrated! I thought that after 5 weeks I would at least be done with the surgery and would just have to deal with the healing. Now it starts all over again, back to 5 different drops 3 times a day, can’t lift anything, and probably the same number of weeks to recover. (He also has to remove the oil from my eye at some point…more surgery!). I would have opted not to go through this If it hadn’t been for the possibility of complete vision loss, Anybody else have these issues?

    • Hey Sandie,
      good luck on Monday..sounds very much like my experience before the bubble “went”..I saw what I thought were flying bugs and was at times swatting at’s weird..hope you get a great report! keep me posted.

  25. To all of you going through or expecting to have surgery for a macular hole, just keep in mind that the surgery is easy, the facedown is difficult, but there is generally a successful outcome. Be strong and follow instructions. Our vision is so very important and we can’t take it for granted.

    • Doctor appt went great. Macular hole (stage 4) closed and looking as good as my good eye. Bubble is at 30% and now divided into a smaller one attached to a larger one. Doc was impressed with how everything looked for so early on. The only issue I have is a suture granulomatous which hopefully will resolve with more steroid drops. I am ecstatic! We had to cancel our trip to Rome but better to have eyesight

  26. October 21st, had emergency surgery to re-attach my retina. It seems to have worked, because the vision in my right has become much clearer, almost to where it was 4 weeks after the 1st surgery. A great relief! Now I just have to wait for the healing t happen… Thanks for letting me vent, I was so frustrated. :-))

  27. Highly myopic and had previous lasik surgery to correct both eyes. The lasik was performed almost 6 months before FDA approval and now they don’t allow lasik surgery if you are above -6. I was -15 on right and -11 on the left. I also had early age catract surgery in 2009 which i found out that I have myopic macular degeneration on the right eye. 4 days ago I saw distortion on my right eye then went to see my opthomologist. He performed a scan and told me it is a very tiny hole that only shows in the scan. He told me to see him in 5 weeks since these tiny holes close by themselves.. If it does not close then we will do a surgery. My right eye went from 20/40 to 20/70. I just don’t know how many people have my issue out there. Any advise well help.

  28. Had great news today..went to the surgeon..I’m one month post op and this was my third visit..I’m officially discharged..told me to live my life..I can fly, sleep on my back and move on..I have new glasses, both regular and sunglasses and they are very helpful..I’m driving and back to my pre macular hole life..I’m so very grateful.

  29. Great news Madelyn! I am still hanging around with my bubble friend 5 weeks later. It is small but there. Getting smaller very slowly.

  30. Hello guys, such a treasure trove of information. I should have read more about my op. The whole thing started during a kick-about at the local astro on the first of September. I was hit in the face by the ball and things went bad. I had severe bleeding in the left eye and was on Maxidex and mylhidanite(something like that) for a week. An appointment at the opthamologist on the 18th of September revealed a small macular hole which had increased in size by my second appointment on the 24th of October. I had surgery on the 8th of November which was painless due to a full-body anesthetic. I’m 7 days into a 14-day posturing plan now, and I’m completely fatigued and becoming restless. I failed to research adequately and did not get all the supporting equipment. . . . I hope I get some great news when I see the doctor on the 25th of November .

  31. Morning Kay,
    I am six weeks post op, having had my macular hole surgery on Oct 10th..we all get basically the same operation and then it’s up to you..the facedown protocol is the most important part of the are almost’s a medieval and primitive way to recover, but I’m sure on the 25th you will be told that you’re on the mend..don’t be surprised if you still look down while walking for a becomes a habit..Please keep us posted as to your progress..I’m doing great and you will as well.

  32. Truly appreciate the experiences shared by all the contributors. i am based in Singapore and in the process of setting up my date for surgery for a macular hole in the next couple of weeks. It is hard to come by personal accounts of others and thanks to Long Row we are learning several things. I am keen to know about the experience of others to regain the ability to read – book, computer screen etc. using only the affected eye. How much is the residual distortion? Would you be able to manage if this was the only functional eye? Look forward to any inputs.

  33. Thought I would check in almost 4 months post op for stage 4 macular hole. Issues I am experiencing are: blurry central vision in the eye especially at a distance. My near vision has changed in the eye so that it is different from my good eye and makes it a bit of a problem to read things. I still get what I would describe as white bubbles appearing to rise in the outside corner of the eye but technically they are probably going down;) sometimes the eye aches. I don’t go back to the surgeon until May. I am wondering if I could be developing a cataract this soon. My vision is good with both eyes but I do feel a bit off. If I had to rely solely on the macular hole eye I could function but definitely could not drive a car. My optometrist told me that if I develop a cataract in my good eye that removal would not be recommended.

  34. Hello guys
    So I’m some 3 months post op and everything is going well. I’m back working since early December, I have a post op appointment on 12 February 2014. My sight is much better. I still can’t read very well with the operated eye and I suspect I might have to get my prescription revised. Most importantly I’m back involved in sport and activities though I wear protective eye wear a la Edgar David’s. If any one in Republic of Ireland needs a posturing chair I have mine as its a large item I now have no use for, and its pitifully difficult to rent one in the country.

    • Hi Kay ,
      My mother in law has had an operation on her eye today and I have had no success what so ever at finding a chair to rent !! I was wondering do you still have your chair ? And if so what part of Ireland are you based? Or could you point me in the direction of where I could rent or buy some equipment? I’m glad to hear that you are on the road to recovery.
      Many thanks

      • Hello , Paula I live in south west Dublin and you can have a lend of it if you would like. I might be going for a follow up OP later so might still need it at a later date.
        You can reach me directly at


      • Hello Kay and Paula,

        I am so glad I found this site and your comments, as I have been struggling to find any Irish information on this. My Mum is due to have a macular hole repaired next week in the Eye and Ear hospital in Dublin. I was wondering if you Kay, or your MIL Paula, had the surgery there and how was it? We are very scared for her as she is in her late 70s and we have to travel from Munster, but know she has to give herself every chance to save the sight in her affected eye. The hole developed immediately after she had cataract surgery so we are very worried that something else could go wrong that we haven’t even thought about. Also, the consultant said she would get a chair afterwards to help with the posturing, but now I’m wondering if he made a mistake and we have to source one ourselves? She is dreading it and I hope she won’t get ill from lack of sleep etc as she will have to posture for 10 days in total.

        Thanks in advance for any local advice you could give.

  35. I am set for vitrectomy in June. These accounts are very helpful. My doc said postop I have to be face down for 7-10 days. Can’t fly for 2 weeks. I can handle that – just hoping for restoration of vision in left eye. Right eye is good. Will come back and give my account postop.

  36. Hello Constance, goodluck with your op.
    make sure to plan ahead, get the supporting equipment for your posturing ready and plan your days for the period you will be posturing: Nutrition , entertainment and daily chores

    If you read, get some books, and a radio/music.
    Make sure to book a body massage as your back would surely be sore after posturing

  37. My last posting was October 2013 when I had emergency surgery to reattach my retina. I had another surgery on December 9 to replace the heavy oil in my eye with a lighter one. It is now May 21 and I am still waiting for the vision in my right eye to improve. I have seen the doctor on a regular basis for laser therapy. He was concerned that the retina might not be healing. However I saw him on Friday May 16, and he said that the retina is finally attached and healed, but the pressure in my eye is low, so it’s back onto the steroid drops (Maxidex) to raise it up again. He has told me that as long as the pressure is good, he will remove the oil in December 2014, one year after my last surgery. I guess I was one of the “lucky” 5% that had my retina detach after surgery (not!). It’s very frustrating because I still can’t see any better than after the 1st surgery, It’s like looking through a glass brick, very distorted. I am able to read, watch television, work on the computer and drive, but I get very bad headaches because my left eye is taking all the strain. This outcome had a 1 in 1000 chance of happening and I sincerely hope that my next surgery will be the final one. Thanks for posting about your experience, it has been a great help.

  38. Haven’t been on here for a right eye (operated in October 2013) is going is 20/25 with no issues, however, I am also in the rare 10% who develop an “issue” in the left eye..started to notice some distortion and immediately went to check it out..seems there isn’t a hole YET, it isn’t a pucker, but the OCT shows an irregularity which may or may not become a is 20/20 even though a bit “off”..going for monthly OCT’s and playing a watchful waiting regimen..wish me luck..apparently I’ve learned that a separation of macula from retina as you age is perfectly normal and occurs without incidence in most my case, however, I have what is called VMA..a vitromacular’s trying to separate, but a piece is holding on causing the distortion..hopefully it will separate without surgery..I’m able to read, drive and function with both eyes for be continued……………

  39. I am so glad I found you guys. I am scheduled for macular hole surgery on June 19. Doc said 1 week head down. I don’t think I can do it. I have neck and back issues. He said there is another gas he can use and prob no head down, but it will cause a cataract sooner and it will take twice as long to disappear. I am torn. I know I sound like a baby, but I really don’t think mentally or physically I could do the face down. Thanks for listening.

    • Dear Sue,
      You do not sound like a baby….can’t imagine 1 week face down with neck and back issues. I had a vitrectomy in Canada 1 year ago and only had to be face down for 3 days, which seems to be the standard here. From my research, I understand that there are some doctors now who don’t require any face down positioning with good results. I guess it all depends on what clinical results your particular doctor has faith in. At any rate, whatever ‘method’ is chosen, a cataract will most certainly follow and is dealt with very simply. Bottom line…choose an option which will be the least stressful for YOU. Wishing you all the best.

      • I have had 2 macular surgeries, one had to be face down for 7 days and one with no face down at all. Two different doctors. The only thing I couldn’t do was lie on my back. Sure beats face down.

      • I assume, perhaps incorrectly, that the two surgeries were done on different eyes. What reason, if any, was given by the doctor for no face down? How would you contrast the results of face down v. no face down? Wish you well.

      • The doctor who doesn’t have his patients in face down position is a renowned retinal surgeon from LaJolla, CA, area and I forgot his name. He absolutely does not have his patients do the face down. He said it’s not necessary. I did just fine. I know he conducts seminars all over the US on this.

    • I feel very blessed..saw my doc last Wednesday..from the results of the OCT left eye..vitreous has finally separated without my even knowing hole and vision in both eyes is now 20/20..can’t tell you how relieved I am and how lucky I feel..

  40. I am in Toronto, Canada and my surgeon is Dr. Armagon who also does not require his patients to do the face down. I believe it has to do with the weight of the gas that is inserted in the eye after a Vitrectomy. He is at the Ophthalmic Consultant Centres Inc. (OCCI).

  41. Your journal and the subsequent responses have been so very helpful to me! Thanks so much !
    I am now 6 days after surgery and have been given permission to have heads- up! It feels funny as though i should still be down. The bubble becomes perfectly round when I am head-down and feels more as it should-
    I still see a bit of a wavy line when I look out above the middle bubble line at the top of my eye. but can read with that left eye much better than before the surgery. I wonder if it will improve or like you said it will always be a bit imperfect. At least it is better and not worse!!!

    • Thought I would check in after almost a year post vitrectomy surgery. I ended up getting a cataract very early on post op which really made the outcome of the surgery hard to tell how things were going to end up. I am three weeks post cataract removal and things are so much better. Using both Eyes I feel quite back to normal. The surgery eye does still have a distortion in the central vision but just something I have to live with and using both eyes I hardly notice it. I am pleased with the end result but it sure was a long time getting everything fixed.

      • Hi Sandie. Don’t know if you still read journal. Was wondering if you still experience ‘bubbles’ rising at the outer aspect of your visual field. You mentioned these in an earlier posting. Interested to know, as I have had 2 MH ops [in] both eyes recently, and I am having a similar problem both eyes. Don”t get me wrong. I will probably just have to live with this but just interested if yours went away eventually. With thanks.

  42. I had macular hole surgery. Now I can see above the waterline but everything looks foggy or hazy. This morning it is very foggy. Is this what others here experienced? Your feedback is appreciated.

    • Mike, my vision above the waterline was clear, not foggy. Others may have had a different experience and will hopefully chime in. The haziness may disappear in a day or two. If alarmed, like any health issue, you should contact your physician.

  43. Thank you very much for responding so promptly. The haziness appears to be worse after getting up in the morning and clears up somewhat during the day. I see my eye surgeon next Wednesday. Today is Saturday. I did not want to call the emergency on call number if it is nothing to worry about. The surgeon inserted a new lens while repairing the macular hole. This is a great forum for exchanging all sorts of useful information. Thank you for setting this up!

      • You might see some haziness early in the morning, good to hear you had a new lense inserted, means no worry of future cataract surgery for you and no posturing which without a doubt makes life unbearable for 7-14 days .
        Rest well, eat well and get well soon.

      • Kay, thank you for the information and well wishes. The haziness is slowly going away, it got better with each passing day. Today it is hardly noticeable. I had my post op examination with my surgeon this week, my eye pressure is on the high side, and there is some post op inflammation, they are being treated with pills and drops. My vision is now 20/80 and 20/50 seeing through the pin holes. My surgeon said it will take several more weeks for my visual acuity to return.

        The best news is the computer images show that the hole has closed – Yes! I am most thankful to be living in this time and space. Before 1996 there was no such procedure and people with macular holes were helpless as their vision deteriorated.

        Once again, thanks to longbow and Kay for facilitating and sharing information, sentiments, encouragement and advice.

      • Great to hear you are doing well, I can agree with you on feeling lucky to be this side of technological advances in the field of macular surgery, I’m just touching 30 and can’t think of life without my left eye.

        I still can’t see too well as my sight was poor before the OP and I used prescription glasses but I don’t have a “hole” in my vision. I do appreciate this information trove provided by longbow because as I discovered during my OP it is the only one available on the great ocean that is the internet.

  44. I am now one year post op for macular hole vision is 20/20 in the eye with a very slight longer need corrective lenses to is good!!

  45. I found your posts really helpful since I had macular hole surgery on October 28. I had lost pretty much all my central vision in my right eye and my overal vision was affected. The surgery seems like a miracle to me. I tested at 20/30 at my two week checkup. I’m back to running now, 5 weeks later. I still have some distortion and a small blind spot, but I can easily work around them. Thanks for this information – it has made my recovery journey easier.

  46. This dialogue has been very helpful to me. Thanks to all who have participated. I have a macular hole in both eyes (one of those rare cases–NOT). I am having surgery on the left eye (smallest hole) on 1/23/15. [The doctor] will use an air bubble and not gas and I only have to be face down for 2 days. The right eye has a much larger hole and the surgery on 1/30 will consist of placing a gas bubble and I will have to be face down for 7 days. I have had blurred vision with a significant loss in my ability to see. Outside of the blurriness I don’t seem to have the distortion that I have read about in some of the other dialogues. I can see larger blurred objects but can not read. I had cataracts on both eyes removed about 4 years ago. At this point, I am praying for healing and restoration of my vision.

  47. Hi All, I had surgery for my macular hole on Jan. 6 and spent a week face-down. It was pretty terrible, but I hope it will be worth it. I got all the positioning equipment I could rent from What I didn’t plan for is that there was no way to position myself face-down and still be able to read out of the reading part of my bifocals. So it was audiobooks all the way – 8 of them! At my 1-week post-op visit my surgeon said it is looking good. Today, it’s still like looking through the bottom of a bottle – blurry all around. I can’t see above the bubble yet. I’m hopeful and the postings here give me courage and patience. Thanks.

    • I am now 3 months post op. My left (operated) eye is still messed up – distortion like looking through bottom of a bottle. The surgeon said that the lens implant may be stuck to the little sac in which they insert it. Whatever, I don’t think my lens is reacting properly to light. They took pictures of my retina again on Monday. The good news is that the hole has closed; the bad news is that there is a hole underneath the top layer. I’m seeing my doctor next week and I’ll get clearer on what’s up.

      I wear bifocal glasses. As you might guess, with the vitrectomy and the cataract surgeries my prescription for my operated eye doesn’t work at all. About a month ago a month ago I decided to try an intervention. I went to LensCrafters and asked them to remove the left lens and replace it with a clear lens. Viola! I can see much better – not perfectly, but better. LensCrafters charged me $25, which counted as a donation to their foundation. That worked for me.

      • You are the first person who has had problems with this process that has commented on this site. I had a vitrectomy & cataract surgery in Sept 2013, to repair a macular hole. then my retina detached and I had emergency surgery to re-attach it. The surgeon put in a heavy oil tamponade to assist in healing in Oct 2013. In Dec 2013 I had further surgery to replace the oil in my right eye with a lighter oil and here we are 16 months later and I still have the oil. I see the surgeon regularly, but the pressure in that eye is too low to remove the oil. I have the same level of vision, like looking through a glass brick. I am so frustrated. I guess I am one of the ” lucky ” 5% they talk about in the literature. Welcome to the blog.

  48. got really wonderful news today..saw my retinal specialist for a checkup..the left eye which was at risk for developing a hole since last year because of traction on the macula has resolved on its own..the adhesion separated normally and there is no danger of a hole vision now is 20/20 in both eyes (the right was operated on in October 2013 for a macular hole)..I wear readers #1.50 and nothing for distance or driving..I am extremely relieved and grateful..I’ve had great doctors and very good luck!..I wish the same for everyone on this site.

  49. I had my vitrectomy surgery on June 1st 2015…I had my head down 95 percent of the time for one week… Went to doctor yesterday for my one week exam he says everything looks fine… However I have a blotch on the inside of my eye that the doctor cannot see… It seems like the whole world has closed.. When I put the phone close to my eye I can’t read the print but I still see the blotch….does anyone have such a problem?

  50. Charlie, are you sure it’s not the gas bubble? If it is, it will soon diminish and go away. As it gets smaller, the bubble will jiggle and move around.. My gas bubble disappeared on Day 15.

  51. it’s not in the bubble because when I look over the bubble it’s still there I think it might be a blood spot… hopefully it will go away by using the drops

  52. I am going to keep my head down as much as possible until the bubble dissipates….. hopefully the block will disappear soon

  53. Charlie, hope you will tell us how it turns out and what your doctor thinks it might be. I don’t think anyone on this blog has experienced what you describe.

  54. Hi All, I’m 6 months out from my vitrectomy. I continue to have a lot of distortion in the eye they operated on, even though the hole has closed. My macula look bumpy, and I fear that is going to be the way it is going forward. The lens they implanted in that same eye corrects my nearsightedness in that eye, but since it is distorted it doesn’t help. In fact, the difference between the distance vision in my eyes is so acute that my brain can’t compensate – it’ weird. My cataract doc wants to hold off on doing anything to my right (non-operative) eye, because if something happened during that procedure, I’d be essentially blind. I can live with a light cataract in that eye for a while longer.

    This whole process has made me value my eyesight even more. Thanks to everyone for giving me some reference points along the way.

  55. Robert, just think about what I was told re macular hole. Surgery will likely stop the hole from getting larger and prevent total loss of sight in that eye. But surgery is no cure. It leaves a “scar” in the eye and a certain amount of distortion will always exist. The distortion in my right eye has improved over the last four years since surgery but is still there. Hope you will keep an open mind about cataract surgery in the other eye. It’s a realtively safe procedure and could enhance greatly your quality of life.

    • Robert, I totally agree with the above comment. I had a vitrectomy 2 years ago and still have distortion which will probably never improve. I can only read large print (think headlines!) with my ‘bad eye’, but peripheral vision in that eye is quite good. I will have cataract surgery on my ‘good eye’ in November as I will otherwise be in danger of falling below ‘driving level’ which for me would be unacceptable. Cataract surgery is very safe, and now with all the new lenses available can correct other vision problems such as astigmatism. According to my cataract surgeon I will only need reading glasses once I have the operation. Cataracts only get worse and cannot be corrected by any other means. Everything in life carries risk, but in this case, I think that risk is very minimal. Good luck with whatever you decide.

  56. Thanks, Janice for the sage comment. I think I thought if the hole closed my eyesight would be good, and I read on this listserv that many people had that experience. I’m not too worried about the cataract surgery. I have excellent doctors, but they are very conservative. Right now my cataract isn’t giving me any problem, so there’s no need to take even a minimal risk. Good luck with your other cataract surgery – I’ll send you Pink Rays.

  57. Thank you too, longrow. I didn’t read your comment until after Janice’s. I’m glad to hear that you’ve seen improvement over time. It gives me hope. BTW, I’m not suicidal or anything. I’m a very happy camper. My motto is “Isn’t that interesting?”

  58. Interesting reading all comments. Last September I noticed when reading the on-screen TV guide that my vision in my left eye appeared to fluctuate or pinch in the middle when reading. So in looking at the typical eye chart, the large “E” would fluctuate between E to a B, back to E. In visiting my eye doctor, she was very surprised to find that I had developed a macular hole at my age (54). She sent me to a retina specialist who recommended surgery. I should have done more research prior to surgery. I was told about the gas bubble and that I would have to keep my head to my chest, but the the extent of the laying face down..not so much. Was told not to sleep on my left side, use a plastic eye cover when asleep, 3 different drops, etc. My vision seemed better as bubble dissipated, but the further I got (months) the vision started to become blurry. I was nearsighted from the age of 8, had lasik back in the late 90’s which resulted in flip flopping my nearsightedness for farsightedness. Could no longer see what was in front of my face, but no longer needed glasses for distance. So at 3-6 months out, I returned to my surgeon on a monthly basis and then as blurriness got worse, I called concerned I might have reopened the hole. No, images showed the hole had closed, but there was some rippling. So what can be done to improve the blurriness? . . . I was told to go back to my eye doc to see if the tiny cataract in that eye was now big enough for that surgery to be done. With that parting advice, (he) washed his hands of me. My eye doctor spent a good hour trying to see if my vision could be improved with glasses as the cataract was not anywhere near requiring surgery. The blurriness is so bad that If I already didn’t know the first letter on the eye chart was an E, I wouldn’t be able to tell. Very frustrating situation, and makes me worry greatly about my other eye. I have frequent headaches and neck and shoulder issues as I find I am always adjusting to look out of my good eye. Guess I need to seek out another retina specialist for another opinion. Driving in general has changed as I have to really exercise caution when changing lanes or turning to my left, and night driving is also more challenging now. Thanks for letting me share my experience with my macular hole. It is very difficult to express my experiences and challanges to others who haven’t gone through something like this. Any ideas or suggestions appreciated.

  59. I went to Dr G for my 3 week examination… He dilated my eyes took some pictures and looked inside …. I was elated when he told me that the hole was completely closed… I asked about the blue blotch again and he told me that my eye has to heal and he will see me in a month… Vision in that eye seems to be getting a little better daily and it seems that the Blue blotch is getting lighter and moving out of the way

  60. The bubble has now split into two bubbles… Anyone have a similar experience?… Does that mean that it’s dissipating? I welcome any comments … Going to the doctor again to check my pressure on June 30.

  61. After 30 days post op I started to have a lot of headaches field vision problems and I had to wear sunglasses all the time and Dr G discovered that the pressure had risen in that eye…. He fixed all that by changing my drops I figured I would let you know just in case any of you run into the same type of problem… If you do let your doctor know

  62. Sorry, Charlie. While I liked your poem, “Seeing Eye Blues,” and even better the rhyme scheme, I can’t yet bring myself to publish verse re macular hole.

  63. It’s not a poem…it’s a song…..I will post the link when I finish recording it
    My new drops are Flourometholone….no headaches since I started them…..the old ones were Prednisolone….if you are using them and have headaches, check with your MD

    • I had headaches with Prednisolone and it was because I was more sensitive to its effect than most people – it raised my eye pressure. My retina doctor gave me Alphagan for that surgery and my cataract doctor gave me Combigan, both glaucoma medications, to bring the pressure down while I was taking Pred. And it worked fine with no effects after the Pred was done, and I stopped taking the glaucoma drops as well.

  64. I’m about 9 months from my vitrectomy on my right eye and it has healed well, just a small distortion. The expected cataract developed. I had it done on June 3 and my left eye on June 17 (I had a small cataract already and I needed both eyes to be done because I was so severely nearsighted, glasses could not manage such two different eyes). It all went well with a small bump in the road regarding my antibiotic. I was allergic and it had to be changed, which was a bit chancy for me since I have developed sensitivities to many because of an unrelated infection in the past. But it all worked out. I now have good vision, good enough to drive, and for distance. My my reading vision is awful. Strange after being so nearsighted all my life! But I knew this was going to be the result, and I planned to continue wearing glasses to correct astigmatism, so I didn’t care. The new glasses will eliminate the close vision problem. I’ll be getting my new glasses in another week or so and I am hopeful that this journey will be complete then.

    I am very happy with my vision despite its imperfection because I have seen firsthand how bad things can be and this isn’t it by a long shot! Thanks to everyone and their information, it’s helped me a lot.

  65. In searching the Internet to try to find answers to my concerns regarding my recent macular hole surgery, I ran into this blog which has been very interesting and helpful. My macular hole was discovered by my optometrist at my annual checkup on 10/2/15. I consulted an ophthalmologist who recommended vitrectomy surgery. My husband and I had a long trip planned and would not be returning to the states until 12/11. My doctor felt that my hole was fairly new, three weeks, and felt there would be no problem in waiting until 12/14/15 for surgery. My doctor has been performing this surgery for 20+ years and no longer requires a long face down period. After my surgery I was required to keep my face down for four hours a day. I could do this by facing down and reading. I am not allowed to sleep on my back and since the surgery was on left eye I am required to sleep on my right side. The doctor after surgery explained to my husband that the surgery went well and the hole was closed. During the procedure he told me that there was a small retinal tear that he repaired with a laser. On my follow up visit the day after surgery he did say that the hole was closed and I was to return 12/24 for another follow-up appointment. Once the eye patch was removed after that first visit I could see very little through the gas bubble but eventually through the bubble I started to see a black hole in the center of my vision like I had before the surgery. As I move my sight around the black hole follows me. I freaked out and called my opthamologist thinking that my hole reopened. He was out of the office and I was told that it could possibly be the bubble that I was seeing. It is not the bubble. On my 12/24 visit I explained my concern. He examined my eye and said the hole was closed and didn’t know what I was seeing. I am now to face down position for two hours a day until the weekend and then I can abandon that requirement. My bubble was 90% the day after my surgery and 55% at my ten day appointment. Have any of you seen that black hole that I am seeing and still had your hole closed? Time will tell, I guess I shouldn’t question my surgeon but I am not feeling confident. Can anyone out there reassure me? Thank you.

  66. No, Alice, I for one didn’t have a “black hole.” That’s a new one on me. Not to say that something’s amiss. Everybody’s eye will heal in a different way. But, yes, yes, yes, you should question the surgeon, any surgeon. If dissatisfied, get a second opinion or a third. Hope you’ll get back to us.

    • Not all procedures are successful. I had my surgery in Sept 2013 and I still cannot see out of my right eye. My doctor did laser just after my surgery and 2 days later my retina detached. I had emergency surgery to reattach it. A tamponade (heavy oil) was inserted and two months later replaced with a light oil. Since then I have seen my Dr. regularly but because my eye pressure in that eye is low (8) he doesn’t feel that he can operate again because he believes it would be detrimental to the eye, although he doesn’t say he will not be doing the surgery in the future. So here I am 2 years later still unable to see out of my right eye. I decided to get a 2nd opinion and was told by a different ophthalmologist that he wouldn’t operate, that there is nothing to be done. I have decided not to go back to my original Dr and resigned myself to the fact that I am one of the “lucky” 5% whose surgery failed. Why my doctor couldn’t tell me that a year ago I have no idea. In hindsight I wish I had taken my chances and not had the surgery to repair the macular hole. (The original surgery did repair the hole, but I believe the laser treatment is what caused the retina to detach and created a bad situation). So yes, if (anyone is) unsure, please get a 2nd opinion, even if it’s not what you want to hear, at least you can make your decision for yourself. Fortunately I am still able to drive, read and do my work (accountant) with just one eye. (It’s legal to drive here in Canada with only one eye). Long row, I have been following your blog since before my surgery and I appreciate the opportunity to talk about my experience. Good luck Alice!

  67. As an update, on 12/31 I saw my doctor again. My bubble is still at 50% (surgery was 12/14). I am still seeing a large spot in my central vision . My doctor explained it as photo sensitivity (similar to what you see after a flash bulb goes off) and it should start to lighten up and eventually disappear. He said the hole is still closed. When reviewing macular degeneration and the symptoms I see illustrated this same cloudy spot that I observe In my central vision which is not getting smaller or lighter. I did read an article that says macular degeneration can be a “complication” of macular hole repair. Has anyone had this “complication”? My next appt. is 1/14/16. I would think being an ophthalmologist retina specialist he should be able to diagnose macular degeneration when he sees it. I am still confused and concerned. After this next appointment and after the bubble resolves I will get a second opinion. Thanks for listening.

    • This is Alice again with an update. I saw my surgeon 12/31/15 and I explained to him that I still had the black hole in my center vision and now that the bubble is smaller I am experiencing peripheral vision loss. He told me how beautiful my pictures were of my closed hole, textbook picture, and he said nothing about my other complications. He wanted to know how soon I was leaving for Florida and recommended a specialist there. At the previous appointment he said I could not go because of the altitude change from OH to FL. So now that I have complications he does not want to address he suggests a route that would get me to Florida within the altitude requirement. We are now in FL and I was anxious to get a second opinion. I had my follow up appointment with a macular hole specialists here in Florida 2/10/16. My bubble is now totally dissolved (8 weeks since surgery). The doctor stated my macular hole is closed. He said he wished he had better news but my peripheral vision loss is permanent and will not return. He feels that the area of peripheral vision loss leaves no doubt that it was caused by the way the gas bubble was inserted. There was air transference that caused the damage. He said the black hole in the center of my vision might improve. I am devastated. To those out there contemplating a vitrectomy for a macular hole think long and hard. If you can live with the vision that you have, PLEASE, do not have this surgery. My vision before the surgery only showed a bend in a tree, or a crooked fence post, or a wavy center line when driving. Now, I am nearly blind. I wish I had never had the surgery. I cannot tell you how stressful and disappointing this is and there is nothing anyone can do about it. I only hope perhaps I can help others when they hear about my disappointing results.

  68. Many thanks for this site, Longrow. It’s a great resource and there is very little on the net from the patient’s perspective. Had macular hole and cataract surgery in my right eye at the same time on Monday 25 January in Bangkok, Thailand. At 61 my cataract was not yet interfering with vision but the surgeon recommended doing it, so as to avoid another op to do the cataract within a year or so. The macular hole is small, under 200 microns. Luckily I was being monitored for cellophane macularpathy (wavy lines on the Amsler grid discovered by an optometrist) for about 15 years and was diagnosed as having an impending macular hole two years ago. Since impending holes can resolve themselves, my surgeon didn’t recommend surgery until the hole went full thickness which happened last month. We had discussed a Jetrea injection as a remedy for impending macular hole but it has only just been approved by the Thai FDA and my specialist didn’t recommend it. A retina specialist at Moorfields Eye Hospital, in London, UK, where Jetrea has been in use for longer, whom I had consulted for a second opinion, fully concurred with the decision not to try Jetrea, due to the greater risk of loss of vision than from surgery, in his opinion, and to uncertain results from what is still effectively an experimental drug, even though it is now approved by the British National Health Service for treatment of stage 2 holes. The Moorfields specialist had not used Jetrea himself (in October 2014) but had treated some patients for bad side effects from Jetrea applied at other hospitals.

    I was instructed to do 5 days face down and have one more day to go. The surgeon admitted it might not make any difference but is reluctant to dispense with it as a sort of insurance policy. I went along with it and have a rather sore neck and shoulders as a result. My left eye has always been my weak eye and is long sighted needing +300 diopter for distance vision. My operated right eye has been my master eye with 20/20 distance vision without correction. Of course, it was a blow to get a macular hole in my good eye but now I find I am one of the lucky 10% at risk in both sides, as I now have a small impending hole in the left eye too but far from needing surgery yet. Anyway, since I could hardly read with my left eye, even with bifocals, I invested in a pair reading glasses and bumped up the diopter for my left eye by +50 vs the reading part of my bifocals to +600, insisting to the optometrist that I didn’t care if that created an imbalance with my right eye, as I wasn’t going to be using it for a couple of weeks. This has really made a difference, even if I will only use the reading glasses for a couple of weeks, as I can now read well with my left eye alone and with a screen lying flat on I my lap. Most people can probably use off the shelf reading glasses for this but they are not normally available in more than +300 and I found it uncomfortable to wear two pairs! I was told to avoid water in the eye for two weeks and not to wash my hair. My wife found a type of foam shampoo that doesn’t require rinsing but can be removed with a damp towel. I have 3 types of antibiotic and steroid drops 3 times a day plus an ointment once a day and artificial tears every hour for 2 weeks.

    During the macular hole surgery I was surprised to be able [to see] syringes and forceps very clearly coming into my eye and working away at removing the vitreous, pumping in globules of blue dye to stain the membrane and removing the membrane which floated away piece by piece in the forceps. It was like watching a YouTube clip of the procedure from the other side. Another thing that surprised me was that, immediately after the procedure, I was able to read my watch in sharp focus about 2 inches from the operated eye, which I could not do before the op. My gas bubble is still quite big but I am now just starting to see a little bit beyond it and it seems quite blurry, unless something is only 2 inches away. I am beginning to wonder if I got the wrong lens in the cataract surgery and my eye will now be able to read extremely close up but will by very near sighted, unlike before. The surgeon said he would put in a lens that would be very similar to my previous vision, i.e. good distance but need reading glasses. It is too early to say how it will develop. I will have to wait and see how the vision progresses, as the gas dissolves. I am going back to the hospital on Tue 2 Feb to find out if the hole closed.

  69. George again with a new WordPress account. I went back to the eye hospital on Tue 2 Feb, 8 days after the surgery, and was relieved to be told the hole had closed. However, on the OCT scan there is still what looks like a large blank triangular space with the pinnacle uppermost under the hole closure where the retina is still denuded of retinal tissue. It didn’t look very good to me but the surgeon assured me there is every chance that the hole will fill up over over the coming the months. Vision in the operated eye is still affected by the streaking reflections from the gas bubble but I can clearly see the same defects in my central vision that existed before the surgery caused by the absence of retinal tissue where the hole was. Visual acuity in the eye was the same as before the op – 20/25. I now realise that the bubble had the effect of causing very close up focus 2 inches from my eye when it was bigger. Over the bubble my distance vision seems similar to what it was before the combined macular hole and cataract procedure.

  70. I have had the news I have a hole in the back of my eye. The dr did not even discuss what it was and has ordered a scan in the next two weeks. No questions about driving or my job .

    I work in dentistry so I am devastated. I had headaches for over a month and saw an optician who referred me. My eyesight had drastically changed in my left eye inside a year .

    I had only noticed last month [that] I could not see the tv text with my left eye and cannot read with it with glasses on. When I had my field of vision tested on that eye, I knew something was seriously wrong as the bright light kept disappearing.

    My peripheral vision is good and my right eye is ok. The consultant murmured something about a stage one to her colleague .

    This is a life-changing reality for me as I Iive in the middle of nowhere. [It takes] three hours daily to [get to] work and back. There is no public transport except a school bus. I am just lost at the moment. I am only 54 .

  71. By now, LIsa, I hope you have taken a deep breath and relaxed some. Judging from what you write, your situation is not nearly as dire as you make it. A macular hole is not the end of the world and your vision through the right eye alone may be good enough to keep your job. What is missing, though, is a lack of communication with your doctor. Do not hesitate to express your fears and anxieties. If the doctor does not respond, find another. Let us know how it works out.

    • Hi Longrow

      Thank you for the reply .

      I am in the uk , so use the NHS for medical treatment , there are some awesome people working within it , and some who could use some bedside manner training , it is not an option to find another doctor as such , you get given what you get .

      I have to wait for an appointment to be sent to me for the scans , then no doubt another one to see the original doctor ,..time ticking away .

      I have taken a deep breath but a still in shock about it all , probably because I knew so very little about it all , having not come across it before .

      I treat patients , I am a dual qualified as a dental therepist and dental hygienist , so fine detail and being safe working with needles and rotary drills , and finate detail , an absolute necessity .

      I am passionate about my work and am self employed , contracted by dental practices .

      My first thoughts aside from the finance issues were “how can I work on people if I have lost my central vision ? ” and it is never going to come back ,and glasses are unable to help , it is lost forever .

      I can take the breath and realise the doctor is doing his job regarding scans for confirmation , that is a good thing , after all I take radiographs to confirm diagnosis too .

      Then I thought what on earth can I do work wise , as all my skills are in the dental field , I know nothing else .

      Then I feel bad as I have been lucky so far in my health etc and others my age have not made it this far .

      Very , very , mixed emotions and uncertainty .

  72. Lisa. Sorry to hear about your situation. One word of comfort I can offer is that a Stage 1 macular hole, if that’s what you have, is actually an impending macular hole which has not yet gone full thickness. Once it has gone full thickness and is still under 400 microns in diameter, it is a Stage 2 hole. I knew I had a Stage 1 hole for two years before it went full thickness in Dec 2015 and I had surgery on it on 25 Jan this year. An impending macular hole can still cause symptoms, as traction on the retina has caused an empty space behind the tissue that is still covering the macular. If you are, indeed, at an early stage, the chances of successful treatment that will prevent the condition from getting worse and might also restore vision by one to two lines on the optical charge are excellent. Surgeons can even work wonders with Stage 4 macular holes that have been left untreated for two years.

    I am British too, although I live in Thailand and chose to have my surgery done here privately, as I am lucky enough to have insurance. I am familiar with the NHS. You can get assigned to a world class consultant free of charge, if you’re lucky, but you can also get some duds, or even capable doctors who are offhand with patients because they know patients don’t have a choice. The system has pluses and minuses but is better than government health care in most other countries. Once you are armed with more information, you will be able to question your consultant in more detail. Before I made the decision to have surgery done here I got a second opinion from one of the UK’s leading vitreoretina specialists, Mr Eric Ezra, at Moorfields Eye Hospital in London. He is not covered by my insurance company and the consultation cost me £550 including the necessary OCT scans but I thought it was well worth it to confirm that my surgeon in Thailand was on exactly the same page. I have seen Mr Ezra several times over the years and every time he made a point of not letting out of his consulting room until he was certain I had no further questions or doubts. I don’t know, if it is an option for you to see someone privately for a second opinion but, if it is, it would be worth considering.

    One thing you should know is that the NHS last year approved the use of an injection of Jetrea (Ocriplasmin) for the treatment of Stage 2 macular holes as first line treatment as an alternative to surgery. This can be used for macular holes where there is traction (i.e. the vitreous is still attached to the retina, creating the tension which causes the hole) and there is no epiretinal membrane (or cellophane macularpathy) which is where the tension caused by the vitreous tugging on the retina has caused the inner membrane to go crinkly, making straight lines look wavy, before it caused a macular hole. In the US Jetrea is also used by some surgeons to treat Stage 1 macular holes to prevent them from going full thickness. Jetrea was only approved in the US in, I think 2013, and in 2014 in the UK. So it is still rather experimental and there is controversy about its use amongst ophthamologists. I believe the success rates to date in the UK are around 40-60%, which means that aound 40-60% of patients will go on to have traditional macular hole surgery. The advantages are that it avoids the risks of surgery and avoids accelerating the development of cataracts, which is an inevitable side effect of vitrectomy surgery in patients who still have their natural lenses. However, it is not known what the effects of Jetrea might be 10 to 20 years after and a small percentage of patients react badly to it, suffering diminished vision. Also you have to endure several days of light shows in your eye and increased sensitivity to light immediately after the injection. Some patients, however, have been delighted with the results of Jetrea and avoiding cataract surgery as a bonus. See positive and negative results of Jetrea here and here Of course the same results either way might have been achieved with surgery. I was not suitable for Jetrea, since I had epiretinal membrane and, anyway both my ophthamologists were in the anti-Jetrea camp, as they felt that the results from surgery were a lot more predictable and the method has been in use widely for around 20 years already, so the long-term effects are known.

    A word about catacts. If you have the beginnings of one, it is better to have it done before macular hole surgery or during the same procedure, as I did. You don’t want to have to deal with your vision clouding over a few months after the operation and there is some evidence that cataract surgery after macular hole surgery creates a heightened risk of the hole reopening.

    I hope this is some help to you.

  73. For myself I had a bit of a panic yesterday. It is just over two weeks since my MH and cataract surgery and I have been seeing floaters in the operated eye that look like hairs or cobwebs coming into my eye plus some small black dots. Initially I was not too worried as I assumed the cobwebs were strands of non-liquid vitreous left behind when the liquid vitreous was removed in the vitrectomy and that the black dots were the remnants of the gas bubble. But knowing that there is a heightened risk of retina detachment after retina surgery, I decided to check the symptoms on the Internet. Finding that cobweb floaters and small black dots were two out of the three common symptoms of detached retina, I left my office immediately and went to the Eye Hospital. I got to see a different retina specialist without an appointment and fortunately she confirmed what I had initially suspected that the floaters I was seeing were a side effect of the operation, which may or may not go away. Luckily I have no detached retina but the doctor told me I did the right thing to come in immediately with those symptoms, since detached retina is a medical emergency.

  74. Alice, your situation is very distressing and underlines the reality that there are significant risks in MH surgery, including infection, detached retina and medical incompetence or even malpractice. When a MH is still forming and is only at the Stage 1 or impending level, most ophthamologists will not recommend surgery, as there is still a reasonable chance in most cases the hole will resolve itself. However, once holes have already gone to Stage 2, or full thickness, the odds of the hole resolving itself are very slim, although it does sometimes happen. So the option of leaving the hole untreated means the hole will get larger and progress on to Stages 3 and 4. Ultimately visual acuity may be only finger count, resulting from a serious deterioration of the central vision, similar to age related macular degeration (AMD). So a patient who chooses to avoid to avoid treatment is between a rock and a hard place. If we knew that there was a very significant risk of vision deteriorating dramatically, including peripheral vision, as in your case, which is not normally affected by MH, certainly none of us would have opted for surgery. But for most people the odds are that their vision will be no worse than before surgery, even if hoped for improvement never materialise, which I suspect is more common than our doctors would have us believe.

    Today there is, indeed, an alternative to MH surgery for holes with traction and without epiretinal membrane in the form of Jetrea injection, which in the US and some other countries may also be given for impending MH before the impending hole has negatively impacted vision. I mentioned this in a recent post here. Jetrea treatment also carries its own risks and it’s use is still at a very early stage, although a big benefit for younger patients is that it doesn’t accelerate cataract formation. Patients who have a choice should weigh up the pros and cons of Jetrea and leave surgery as a last resort, if Jetrea doesn’t work for them. However, I think it is hard to advocate leaving a full thickness hole untreated, despite the very real risks of both surgery and Jetrea.

  75. Hi George

    Thank you for your informative post .

    I am still trying to deal with it all , I have had to give up my job as I work in millimetres and cannot see the measurements .

    I have a contrast differentiation in my eyes so cannot shade guide accurately .

    I have my OCT in two weeks and my results 2 weeks later .

    i have stooped wearing glasses , as I get headaches with them .

    I do not know if Jettra is an option for me , but after reading the side effects not so sure .

    I feel the difficult thing for me , is I was one of many who would help you get you better.

    I will have to get over myself as they say X

    • It’s a pity the NHS can’t give you the results right after the scans but they are compartmentalised like that. Obviously you will have to wait for the results of the scans before having any idea what treatment options are. I didn’t like the sound of Jetrea much either but a lot of people seem to have done well with it so far. As there are risks with both and I was probably only a few years away from needing cataract surgery anyway, I preferred surgery. Jetrea would have meant travelling to the UK for me, as wouldn’t have wanted to be one of the first guinea pigs to try it in Thailand and I don’t think my case was suitable for it anyway. But I guess Novartis has done a good job marketing it to the NHS and they must have a very good discount, which would make it much cheaper than surgery fees.

      Keep your spirits up. I know not being able to work at a job you enjoy is devastating but we have to think in terms of doing our best to preserve at least the vision we have and adapting to it. The majority of patients who have the surgery get an improvement in visual acuity of 1-2 lines in the optical chart. That is something we have to regard as a bonus, if it happens but the main objective is to stabilise things. BTW I have read that driving with impaired vision in one eye is legal in the UK, as long as the other eye is good and you can get an optician to certify this for you.

      • Hello George

        Thank you for your kind words .

        Today was a better day for me emotionally and rationally .
        The sun was shining , a clear blue sky , a cold wind , so I wrapped up warm and took the dog for a five mile walk .
        The blossoms were on the trees and daffodils in the fields , and it was a wonderful world .
        Some people will have never seen the colours in their life .
        I know giving up my job is devastating to me , I am working out my notice , but it is the correct thing to do .
        I had a brilliant career , the last two years being my happiest professionally working with the nicest and best clinicians ever , after many years of just getting on with it to pay the bills and raise the children along with my husband , who grafts away in a horrible factory .

        So I am blessed ,in so many ways .

        I have a lifetime holiday in June on a motorbike (passenger ) and I know I cannot be whinging and moaning about my eye , so I will see what the doctors say ,but after two years of saving so very hard , I am sure as hell going to enjoy my holiday 😎

      • Glad you’re feeling better LIsa and that you will be the pillion, not the driver of the motorbike! Sounds like a great trip. It helps to have a positive attitude and that also strengthens your immune system which has to do the work to close the hole after surgery (or Jetrea).

  76. Well an update from me .
    Macular hole stage 3 confirmed by OCT scan. [I was] referred to Nottingham to see a specialist retinal surgeon, date for first out patient appointment is middle of May. [I] saw a private consultant last week who answered all my questions. He is moving areas so unable to do the surgery. He was able to recommend others to me though, so a big help.

    Have had a quote of £7500 privately. Still working till the end of April .

    Macular hole present since Dec last year. They reckon I am four months in without any treatment. Vision has got worse as I see blurred faces now. If closing right eye [it] does not really bother me.

    I have applied for several jobs [and] not got anywhere. So am a bit resigned. I am too old to employ now unless I was able to resume my profession even part-time .

    Can’t do the housewife bit ,it will literally destroy me mentally .

  77. Hi Lisa, Stage 3 means surgery is necessary, as Jetrea injection is only an option for certain types of Stage 2 hole or impending holes (Stage 1). So one less decision to make. Although Stage 3 (400 microns or more in diametre) holes are obviously larger than Stage 2 holes, the outlook for surgery is excellent. Most MA patients achieve a visual acuity (VA) improvement of 1-2 lines in the standard optical chart. From what you say, your VA has suddenly deteriorated in the eye with MA. In fact, this could mean that surgery has the potential to yield a better than average improvement in VA, although every eye and every procedure is, of course, different and nothing is guaranteed. However, you need to be patient, as the improvement in VA may come slowly over 1-2 years, as retinal tissue is gradually restored underneath the closed hole.

    It is good to have had a second opinion for peace of mind but I would think that having the op on the NHS in mid May will be fine. The eye is unlikely to change significantly between now and then, so it would probably not be worth shelling out that much hard earned cash just to get it done quicker privately.

    I should ask the surgeon about cataract, as the gas is likely to accelerate cataract formation. Since I had the beginnings of cataract in that eye, my surgeon recommended doing cataract surgery at the same time. I don’t know if this is an option on the NHS but he should at least talk you through the risk of getting a cataract and what to watch out for etc. Many MA patients think something has gone wrong with their MA surgery 6-24 months down the track, when what has actually happened is that the MA procedure has given them a cataract. Theoretically a rigid face down regime could avoid cataract formation, as the gas would not contact the natural crystaline lens at all but this seems very hard to achieve.

    Don’t give up hope of finding a job or feel you’re too old. Some people appreciate the experience and reliability of older workers. I found an interesting part-time job at 59 unexpectedly after not working for many years and am still doing it after 3 years.

  78. Here’s an update from me, 18 months out from my surgery on my right eye in October 2014. I’ve had my cataracts done now (June, 2015), and all my eye work is finished. I have a little distortion in my right eye still, and that will stay. I don’t notice it. I have adjusted to the drastic change in my vision after cataract surgery (I went from very very very nearsighted to a bit farsighted) and I mean it was a change, but very much for the better. So overall, I am able to just use my eyes and give it all no other thought. I am so grateful for the treatment that was available and how it has helped me, because I would have lost the use of the right eye not that long ago, I understand. The process has taken some time, but I have come out well. I hope this encourages others just starting down this road.

    • Great to hear you are doing well, Claudia. Most MA surgery patients will need cataract surgery within 12-24 months, if they haven’t had it already or at the same time as the MA procedure, as I did. Surgeons seem to have the option of fitting intraocular lenses of different diopters, as well as fancy new soft multifocal lenses. But the multifocals are not normally recommended for eyes that have had MA surgery because they need to focus light on different parts of the retina for different focal lengths. Since MA patients usually have some retina impairment, however small, results with multifocal lenses might not be satisfactory. There is also a greater risk of halo effects. With the standard monofocal lenses, you could choose a diopter for either reading or distance and some people opt for one of each, so they can read with one eye and see distance with the other. But there, again, if there is any retina impairment, this solution probably won’t work so well. For MA patients most surgeons will recommend the set-up you have now got, i.e. both sides optimized for distance and needing reading glasses for close up, as that seems to provide the best results.

      • Yes, my surgeon went over the options very carefully before I made a decision, and he ruled out the idea of distance in one eye/reading in the other from the start because of my retina issue. Also, my myopia condition is progressive, so the correction I have now will not likely last for the rest of my life. OK with me, I am used to wearing glasses and so continuing to wear them (I choose to wear glasses with just a correction for reading and a bit of astigmatism at this time, easier than looking for reading glasses all the time) didn’t bother me a bit. I would advise any vitrectomy patient to begin thinking about the cataract issues once the vitrectomy is healed, because it does seem they are inevitable complications. In my case it developed within a couple of months and by the time I had the surgery, about 8 months after the vitrectomy, my vision in that eye was really poor.

        I think the hardest part of the cataract section of the macular hole story is – the couple of weeks between getting one eye done and waiting for the other one to be done. Just nuts, I was, with such wildly different eyes for that time period!

      • I agree that MA patients having surgery, as opposed to Jetrea, need to be fully aware of the implications for cataracts and should also consider having the cataract down in the MA eye at the same time as the MA surgery. I have seen a lot of accounts online where patients didn’t seem to know what was going on when they suddenly started developing a fast onset cataract. I have worse glare from car headlights at night and some halo effects in artificial light, following the cataract surgery, which I have only had down i the MA eye as the other eye doesn’t yet need cataract surgery. The surgeon explained this is due to the fact that the artificial lens has to be a slightly smaller circumference that the natural lens in order to seat properly with its plastic haptic strut, which he showed me in a photograph of my eye. When the pupil dilates in low light, it can dilate further than the edge of the artificial lens which results in light scattering from outside the perimeter of the lens. However, this effect is also caused by early stage cataracts because they begin clouding over the natural lens from its perimeter inwards. Thus the clouding of the perimeter of the natural lens creates a similar effect to having an artificial lens that is slightly smaller in diameter than the original. Thinking back I was already getting worse glare from car headlights in that eye before the cataract surgery due to the early stage cataract I had, although the halo effects are new. But I can live with it knowing that I want have cataract problems in that eye.

  79. I had surgery on April 1st on my keft eye….today is Arpril 9th…gas bubble almost gone….It was my left eye that I used a contact lens for distance…I do not need a contact for close up….After surgery switched distance contact to opposite eye…surgical eye still blurred .. can see but not real clearly…..I was totally put to sleep for surgery…use 2 different eyee drops 4 times a day…1 twice a day..and 1 eye drop 3 times a day…total 4 different eye drops…dr opened office just to see me the day after surgery which was a Sat… had another appointment 3 days later and said things looked good…tmro April 11 will be 3rd appointment…hoping everything is healing as it should…

    • Mary, some recent studies suggest that macular holes normally close on the surface of the retina within 24 hours of surgery, although it can take some time for the hole to fill in behind the surface. I hope yours will heal successfully.

      In my case I kept my appointment at the Eye Hospital last Friday for OTC scans 9 weeks after the MH surgery. The surgeon had already confirmed the hole had closed on the surface a week afterwards and scans 3 weeks after the surgery showed that a small area below the surface had filled out but a large gap remained below that. My vision was still pretty much the same as when the hole went full thickness before the surgery at that point. The surgeon told me that, since it was a deep hole that we had observed forming for two years before it went full thickness and decided to operate on it, it might take 1 or 2 more years before the hole would completely fill out and I could expect the most improvement in vision I was going to get.

      On Friday he showed me that the hole has completely filled in with retinal tissue, much earlier than he expected. My visual acuity in the operated eye, which declined from 20/20 to 20/25 when the hole went full thickness is now nearly back to 20/20 again (i.e. could read 3 of the 5 letters on the 20/20 line). I was having to use a magnifying glass to read the newspaper before the surgery and for a couple of weeks after the gas bubble went but now I am back to reading it without one (the operated eye is my dominant eye, so the other one virtually cuts out, if the dominant eye is working). I still have some distortion in the central vision of the operated eye. The first letter of a word is often missing and looking at something a cross hair, the vertical line has kink in it right where the lines cross. But I had that for some time before the MA went full thickness.

      I am very pleased with the results from MA surgery here in Bangkok, Thailand. My vision is not perfect but it’s pretty good and, now that the hole has closed and filled out with retinal tissue, the risk of it re-opening is relatively low. Since I had cataract surgery at the same time, as advised by the surgeon, I don’t have to face the prospect of blurred vision due the gas bubble causing accelerated cataract formation.

  80. I noticed odd things happening to my vision while on holiday in 2015. In June I got up to have a shower and couldn’t focus. Then when I went to read, all the words were jumbled. I felt quite panicked and went to a local optician who after looking at my eye told me to go to a&e [?] straight away.

    I had developed a swelling on the back of my left eye which after tests and scans was diagnosed as central serous retinopathy [CSR is a disease of the eye, causing visual impairment usually in one eye and is often temporary]. It and was a watch and wait. I was told to go to my own eye consultant as soon as I got back as it had to be monitored. Easier said than done. Numerous phone calls [and?] visits to the doctor couldn’t get me an urgent appointment. So I didn’t get seen until August.

    After more scans I was told it was a macular hole and I would have to see the specialist eye team from Oxford. It was another 6 weeks for this appointment and then another 2 months before my surgery. Everything went [OK?] except it was a really large hole. I was given the drops and advice [and] was checked the day after. One week later they discovered I was a steroid reactor and it had made my pressure sky high in my eye. [That] resulted in more drops to bring [the pressure] down, more drops to replace the steroids and a visit to casualty [?] next day where the pressures had come down. I could actually see things clearer but not the faces of people. At least their features [were] in the right place!

    I was having a lot of floaters and strings at three weeks. I was handed over to my normal eye consultant. More drops [and] scans. I could sense my sight deteriorating so I immediately thought it’s the cataract forming which was confirmed. So I thought, OK, the next step is to get it removed. But all the people I saw after that kept putting the discussion off until last week again. I was told to sit in the waiting room, and then in 15 mins we will discuss your cataract. So obviously my hopes were high.

    Silly me, it was like a kick in guts when I was told it’s not the cataract causing your problem, so there’s no point removing it. My vision [now] is very poor. I am relying on my right eye. [The doctor] wouldn’t even refer me to the low-vision clinic. He said use your right eye. I came home depressed, but the more I thought about it the more I thought I will only accept it if that’s what my eye surgeon tell me so. I am now waiting for a referral for a second opinion. It has also been found that I have thicker than normal corneas which makes it difficult for them to get a correct pressure reading!!!

    • Very sorry to hear about your problems, Anne. Clearly you suffer from more than one eye ailment but, from your closing para, it was still not clear exactly what has caused your vision to deteriorate so much. I am not sure, if the initial diagnosis of CSR was a mistake or, if it progressed to MH or if both were present. It sounds as if your doctors were muddled themselves. CSR and MH can look slightly similar on a scan, as CSR is a build up of fluid in the macula which may be how MH starts but the difference would be obvious to a competent ophthamologist looking at an OCT scan. Incidentally anyone with CSR should not be given corticosteroids, since a similar steroid-like chemical produced naturally by the body is believed to be a cause of CSR. So ophthamologists should ban the patient from using any product containing corticosteroids, including nasal sprays. If the first diagnosis of CSR was correct, they should probably have avoided giving you corticosteroids from that point and not subjected you to the risks they did. If you never had CSR at all, and it was a misdiagnosis, they are incompetent.

      For reasons of delaying costs I guess, the NHS seems not to do cataract surgery at the same time as MH surgery, even it is well known that MH surgery will cause accelerated cataract formation and that performing cataract surgery after MH surgery is likely to increase the risk of re-opening the hole. Your assumption that your problems after MH surgery were caused by accelerated cataract surgery seemed reasonable and you say that your suspicions were initially confirmed. Later it seemed that they told you the cataract was not causing the problem but apparently didn’t tell you what was causing the problem, or how bad the cataract is. It is very easy for an ophthamologist to tell how bad a cataract is and show the patient within a couple of minutes by taking a photograph of your natural lens. The cataract shows up as an orange area in the lens, which starts from the outside of the lens and works its way in until the whole lens is blurred.

      I would have two main questions: 1) what is causing the problem, if it is not the cataract, and how can this be treated? 2) How bad is the cataract and is it making the other problem worse? So should the cataract be removed anyway? It will only get worse.

      You need to keep pushing the NHS until they give you clear answers to what is causing your problem and what treatment is available, as well as answers about why they are unwilling to treat your cataract. Best of luck.

      • George00x
        Thank you for your reply, A top consultant, an optician and junior doctor all said it was CSR. it was only when I got to my eye specialist [that] he confirmed MH. But they still kept me waiting to see the surgeon. By then the damage was done. I recently was told the cataract isn’t big enough to cause the problems. He said you can’t change the film in the camera if the lens is no good! My lens was fine before all this. In fact that was my good eye. I’m wondering if it was the steroids as I’m now classed as a steroid responder. Whatever has happened I’m left with poor vision in my eye. I’ve asked for a second opinion. If it’s the case that if the cataract could open the hole what happens?. Maybe i should sue! Anne.

      • Anne, you said the surgeon who performed the MH surgery told you it was a large hole. I am not an ophthamologist, just a fellow MH patient, but it strikes me that a large, full thickness hole should have been very obvious from the OCT scans to the top consultant who diagnosed CSR. Perhaps CSR was also present but I would guess it would be unusual to have both together. It seems more likely that one of the diagnoses was incorrect. It seems very unlikely that a specialist would operate on MH by mistake, when it was actually CSR. So we should probably assume it was really MH. In that case, there might have been incompetence involved in the diagnosis of CSR, which is usually expected to resolve itself, that wasted time in getting you the MH surgery. If it was a large hole, [it] would probably not have got significantly larger in 2-3 months, but you certainly don’t want to delay MH surgery more than a few weeks. If you never had CSR at all, it is less likely that the steroids caused serious damage to your retina and vision. But, if you did have CSR, steroids could have made it worse.

        Re the cataract. It is not the cataract itself that risks re-opening the hole. But cataract surgery or any type of surgery creates a bit of a risk of this. The risk should not be exaggerated but it is just less of a risk to have the cataract surgery at the same time as MH, since you know you are going to get a cataract anyway, due to the gas used in MH surgery. Anyway there are probably different schools of thought on this, as many surgeons in different countries seem quite happy to do MH surgery first and deal with the cataract later. As long as you have some usable vision in your operated eye, you should probably not let them fob[?] you about having cataract surgery. The time to have it may not be now but almost certainly there will come a time in the not too distant future when cataract surgery will improve the vision in that eye.

        But for now, the main thing is to find out what is really wrong. Did they confirm that the hole closed after surgery? Normally this happens in the first 24 hours. However, a large hole can take some time to fill out behind the closed hole. Closing the hole is like getting a scab to form on the surface of the hole but there is often a deep gap behind the scab that is filled with fluid. It can take time for the fluid to be pumped out and for the gap the fill out with retinal tissue. The surgeon should have given you detailed information on the closure of the hole and showed you the pictures.

        It sounds as if you have either not been told exactly what the problem is after the surgery or it has not been explained to you clearly. Things can go wrong in MH surgery, either due to bad luck or malpractice. But the most common problems are failure for the hole to close, which can usually be corrected with another operation, and detached retina. Your problem doesn’t sound like either and it is impossible to guess what it might be. Hopefully your second opinion will clarify what the problem is. If not, you will have try to get a third opinion. In that case, I would try to get referred to Moorfields Eye Hospital in London. They have some of the best vitreo-retinal specialists in the UK. If you need this and the NHS refuses to refer, you could consider going privately, if you can afford it. This is expensive and a consultation with scans could cost GBP 600 or so, or perhaps you could get copies of scans you have had elsewhere that they might be able to interpret. I have seen Eric Ezra at Moorfields about MH but I think all of them are excellent.

        I am not a lawyer either and we don’t know yet what has happened to you. So I can’t say if you should sue. However, if you were to get an expert opinion that you had suffered loss of vision due to malpractice by the NHS, you might be able to sue for damages. A lawyer could advise or maybe Citizens Advice Bureau or similar.

  81. I’m 3 1/2 weeks now post macular hole surgery. My gas bubble has gone away but since the surgery I continue to see a dark spot looks like a pineapple with spikes in the center of my vision which blocks out my vision. Have been back to the surgeon many times. He first thought it may be the dye that they inject during surgery but really not sure. Did the dye toxicity test which came back normal. He claims [the] hole is closed and surgery was normal. 2 other Drs do not know what this is either. They seem to be perplexed. Has any others experienced this? I’m very nervous that this will not go away. Can’t seem to find anything on Internet. Thanks.

    • Jack, The most common complications of MH surgery are floaters, infection, detached retina, failure of the hole to close or later re-opening of the hole but this doesn’t sound like any of those. There are also a number of more rare complications. Some complications may be just bad luck and others may be caused by poor surgical technique. If your surgeon and his colleagues at the same medical facility can’t figure out what the problem is, you need to seek opinions from other, more experienced and knowledgeable ophthamologists, as quickly as possible, as any delay could be vision threatening. Try to get a referral to the best person you can and don’t give up, until you have got a satisfactory answer. It is impossible that this is an unexplained condition and you are unlikely to [be] the first person who has ever suffered from it.

      One of the reasons this blog is so useful is that there is a lack of good quality information online about MH surgery, which is a relatively new procedure that went through significant advances only a few years ago with the arrival of high resolution OCT photography. Good luck.

  82. Good evening. I stumbled across your blog tonight while researching my post vitrectomy surgery.

    I am 11 days post surgery. I am at the point now where the gas bubble covers about the lower third of my eyesight. The vision is distorted where straight lines appear to be wavy. My vertical and horizontal blinds appear to be wavy. Did this distortion ever go away for you?

    • Callie, Did you have the same level of distortion before the op? The visual distortion you describe is a common symptom of MH. In my case I still have similar distortion 3 months after the op. After MH surgery there is still going to be some retina impairment in most cases. The closure of the hole is achieved by the formation of some sort of scar tissue which will not be exactly the same as the original tissue. Also it depends a lot on what has been going on below the retina surface, e.g. how deep was the hole and is it filling up with new retinal tissue after the surgery. Again this tissue may not be exactly the same as the original tissue that was displaced by the hole formation and may not have the same photoreceptive functionality. Of course, it will also depend on how wide was the hole and how long it was forming and how long it was full thickness before surgery.

      Most surgeons like to view things in terms of visual acuity (VA) before and after surgery. Essentially the worse your VA was before surgery, the better the chance of an improvement through surgery. Most patients should get an improvement of 1-2 lines on the standard optical chart. However, the measurement of VA tends to ignore the type of straight line distortion you describe, since you can usually read the optical chart in spite of the distortion. Even with blank spots in your central vision, another common symptom of MH, you can still often read small print on the optical chart by looking off centre. So this may also be ignored by VA tests, although big blank spots will, of course, reduce VA. In my case the blank or rather blurry spot in my central vision was starting to interfere with my VA just before the op, causing me to need a magnifying glass to read standard newsprint. Now I read it without a glass but still have the straight line distortion which I can live with.

      As your surgeon will tell you it can take up 1 or even 2 years to realise the full visual benefits of MH surgery. It’s likely that you always have some straight line distortion as a result of the retinal impairment, although this might improve somewhat and you should experience a modest improvement. The main thing though, is that successful MH surgery means no further visual deterioration due to MH.

      • Thank you George for the reply. I have been using Siri’s voice over to listen to the posts on this board and I am grateful for the advice and information I have gotten from the other users and you. I’m using Siri to dictate this reply right now.

        My surgery was performed Wednesday, April 6, 2016. I had a follow up on Thursday, April 7, 2016. Dr. said surgery went well eye looked good. However, due to the gas bubble he was unable to tell me whether or not the MH closed. My next appointment is Friday, April 29, 2016. At that point, I hope he can tell me whether or not the MH has closed.

        I guess it was my misunderstanding that if the MH operation were successful, the wavy lines would disappear, as the wavy lines were the symptoms that lead to the discovery of the macular hole. After reading your and several other post I realize this is not how it works.

        Not having the surgery was not an option for me. The doctor told me that the vision would only get worse without surgery. A little background: surgery was performed on my right eye (my only good eye). Since birth my left eye has had negligible vision (the eye is very long).

        When you only have one eyeball that works, anything that goes wrong with that working eyeball is a huge concern. I had my pity party last night prior to discovering this blog. The bubble is diminishing and I am able to watch television and today for the first time I used my desk top computer. Things look about the same as they were before the macular hole surgery, which is why I am concerned that the hole did not close. I spoke to my doctor today via the telephone. He told me my symptoms right now our typical of someone at this stage post op. I will know more during my next appointment on Friday, April 29th.

        I feel I will be able to keep my job. I may have to do some adjustments to my work place computer. Not sure if I will be able to continue to drive. That is my biggest concern. However, Uber is very prevalent in the area in which I live so I can use them to go to and from work as public transport is not very good in this big city.

        Question; I keep reading that a successful macular hole surgery could result in visual acuity improvement of 1 to 2 lines. How is that measured? From what point is that measured? During the development and discovery of the macular hole my vision has really deteriorated. But prior to the hole I had 20/30 vision.

        Again, thanks for the insights, advice and real life patient stories here.



      • Callie, the surgeon will be able to see for sure if the hole has closed. With the latest type of OCT machines, they can actually see through the gas bubble but I am assuming he only examined you with the slit microscope at your appointment one day after the surgery, which is normal just to make sure all is fine with detached retina starting or other complication. Once the gas has gone he should be able to see with the slit microscope alone whether the hole has closed or not but will only be able to see what has happened underneath the surface tissue with OCT scans.

        I made a lot of pessimistic assumptions based on what I was seeing in the second week of the bubble but they turned out not to be very accurate, luckily. I thought my vision had deteriorated further compared to what it was just the op. But this perception turned out to be partly due to the gas still being present and partly due to the need to readjust to your post operative state without the gas. It’s best to wait till the gas has gone completely and give yourself another week to readjust before rushing to judgement. Whether the straight line distortion improves at all and, if so , how much will depend on many factors. Every eye is different.

        If your VA in that eye was 20/30 before the operation, improving by 1-2 lines on the optical chart would mean that your VA could improve to 20/25 or 20/20. Realistically though I think a 2 line improvement can only probably only be expected in eyes that are worse than 20/40 before surgery but it is possible. 20/30 means that you see at 20 feet what a person with normal eyesight can see at 30 feet. I had 20/20 in my operated eye while the hole was impending and it deteriorated to 20/25 when the hole went full thickness. It is now between the two. Of course it’s possible, specially in younger people, to have better than 20/20 VA and with 20/20 I already had straight line distortion and a slight blur in my central vision but I could still read all the letters on the 20/20 line by looking slightly to the right of the target letter. As Long Row pointed out, there is more to eyesight than the basic way VA is tested by optometrists but it suits surgeons to measure their in terms of VA alone without taking account of residual distortion. Anyway we are still extremely lucky this surgery is available. Before the 70s MH sufferers just had to watch their central vision slowly fading away.

      • George, you are correct. The doctor examined my eye using the slit microscope the day after surgery. He will use the OCT scan on April 29 to determine whether or not the macular hole has closed.

        I have decided to not be a Nervous Nellie any longer. I have to wait for things to settle down and then move forward. Things will be OK. The bubble gets smaller every day and things are coming into focus.

        I need to realize how fortunate I am. Had this hole occurred maybe 20 years ago there would not have been any options for me. But thanks to technology there are options, and that’s a valuable thing to have in life

        This board has been an invaluable resource for me. Thank you for your words and support.



      • The advent of OCT photography in the 2000s has also made a huge difference. Before that it was much harder to diagnose MH and other retina conditions and impossible to get a cross sectional view of what is going on in the retinal layers below the surface. Now it just takes a few minutes.

        We should also not forget cataract surgery which most MH patients will undergo sooner rather than later. Before it became widespread and relatively safe in the 70s, the only option was to wear coke bottle glasses in place of the surgically removed lens.

      • Hi George. I wanted to get some advice from you. I have A post surgery follow up this coming Friday, April 29, 2016 I will have the OCT scan at that time to determine whether or not the macular hole has closed. Do you have suggestions for any possible questions I should have ready for my doctor that day? I’d appreciate any guidance.



      • Hi Callie, Let’s assume the hole is closed. You need to have a good look at the scans to see what is going on behind the surface of the closure. Is there still a gap that may be full of retinal fluid that may be affecting vision? If so, how deep is it? What is the likely prognosis for the fluid to be absorbed and the gap to fill up with retinal tissue, based on similar cases he has seen? Any significant risk of the hole reopening? Ask him about your visual acuity (VA) before and after surgery and the prognosis for any further improvement. I would test your vision with an Amsler grid chart downloaded from the Internet, if you’re not already doing that, to get an idea of degree of blurred or blank spots in your central vision and the wavy lines beforehand and report your findings to him. Look at the spot in the middle of the grid wearing your normal reading glasses and observe any distortion around the dot.

        In the unlikely event the hole is not closed, the normal option is a second operation which usually has a good chance of success.

        If you have not had cataract surgery in the operated eye, ask him what symptoms to look out for and about the surgery, as this will usually be necessary within a year or so. Many patients worry that they are suffering complications from the MH surgery when they start getting the inevitable symptoms of cataract.

      • Thank you George. You have been an in valuable source of information on the subject. I really appreciate everything you have put out there. Regards, Callie.

      • Oh [I had a] CT scan today. Macular hole did not close. Looking at my other options.

      • So sorry to hear that the hole didn’t close, Callie. I think normally the best option is another operation which usually has a good chance of success. Of course, every eye is different and there are many variables, an important one being the size of the hole but even large holes are usually operable.

        Some surgeons believe that using a longer acting gas is useful in helping close larger or more difficult holes with, of course, more time spent face down posturing. Sulfur hexafluoride (SF6) the standard gas in use today is a quick dissolving gas that is suitable for most holes but has only, in fact, been in widespread use for a few years. Before that perfluoropropane (C3F8) was the standard gas which lasts about 6 weeks and calls for 3 weeks’ posturing, if your surgeon still believes in posturing, and there are even longer acting gases.

        Failure of the hole to close is clearly a known risk in macular hole surgery that happens with all surgeons, if they do enough MH procedures. However, since it has happened to you and your vision is of paramount importance, I would strongly advise seeking a second opinion and, if necessary, a third one.

      • Good day, George.

        I had a consult today regarding the possibility of a second operation to close the macular hole. The doctor did not sound optimistic about that possibility. Although, he is consulting with my primary Eyecare physician. My eyeball is shaped like an egg instead of a basketball. The retina is so stretched that they don’t know if it will be able to fuse back together.

        I will wait on the results of their consult and go from there. I am really bummed, but life goes on. I can see, not well enough to drive, but I can see. And the surgery did stop the hole from getting larger. It is a relatively small hole only 294 microns . This may be my new normal.



      • Callie, That is bad news. I am sorry to hear it. At 294 microns your macula hole is small, only Stage 2 which is the lowest level of full thickness hole (Stage 3 starts at 400 microns). I don’t have any knowledge of the eye condition you describe that stretches the retina and makes it difficult for the hole to close after surgery but I am wondering if the surgeon mentioned this to you before he operated. If he diagnosed it but failed to mention it, or failed to diagnose it at all, either way I would personally have some doubts about the surgeon. Sorry to say but I am also doubtful that a failed macular hole operation would arrest the increase in the size of the hole. If it is still open and filled with retinal fluid, logically there is nothing preventing it from progressing and if there is pressure stretching the retina, this would seem even more likely.

        I don’t know where you are based or what choices you have in seeking a second opinion but I would urge you to get one from the very best consultant vitreoretinal specialist you can get find. Your surgeon seems to have now told you you have a rare condition that he doesn’t know how to treat after performing one operation that he apparently thought at the time was going to be successful. Vitreoretinal surgery is not a precise science and opinions vary tremendously between surgeons, as you can see from the division of opinion even on whether face down posturing is necessary and whether Jetrea injection is a viable and safe alternative to MH surgery. Also skill and knowledge levels vary a great deal from person to person and place to place. If you are in the UK, you will find that surgeons at Moorfields Eye Hospital in London routinely treat many rare eye conditions successfully that would defeat lesser surgeons elsewhere. Best of luck.

      • Good morning, George.

        I have complete confidence in my surgeon. I am in the United States in Miami, Florida. The Bascom Palmer Eye Institute is one of the premier eye hospitals in the world, and my surgeon has been treating me for about 12 years.

        I am extremely nearsighted: when wearing eyeglasses the prescription is -27 dpt. So, yes I knew going into this that thr success rate was not as high on someone with my eye condition, but it was my only option.

        Everyone agrees the hole will not get any bigger because there is no vitreous pulling on the macula any longer.

        I will, however obtain a second opinion.



      • Callie, Yes, that all makes sense and glad to hear you are in good hands.

  83. I thank you kindly for this detailed journal – it has put me more at ease than anything else I’ve read. It has inspired me to start my own journal. My surgery is in 3 days. It has comforted me as I’ve read it at least 3 times when I get anxious. It’s very realistic, hopeful and easy to read. Thanks again.

    • Good evening, everyone.

      I am scheduled for a 2nd vitrectomy to close a macular hole tomorrow, June 13, 2016. The first surgery on April 6, 2016 failed to close the hole. I am a special case (highly myopic). I had the typical “coke bottle” glasses, before cataract surgery, because I am so myopic (-27 dioptres). The MH is in my right eye, my “good” eye as I don’t have much vision in the left eye. But, I’ve gotten along quite well with my one good eye all these years and I am hoping the surgery is a success so that I can get my life back. I have wonderful friends who have been there for me these past couple of months with rides to/from work and the grocery store. But, I feel like a burden, though they keep telling me I’m not. I miss my independence.

      The surgeon is one of the best in the U.S. at Bascom Palmer Eye Institute and all I can do is hope for the best possible outcome.

      I’m not a religious person, but I do believe good thoughts bring good things. So I appreciate any juju you can send my way. 🙂

      I found this medical journal article which is keeping me positive:

      I’m glad I found this blog and hope everyone’s surgery is a success.



      • Callie,
        Wishing you all the best with your surgery tomorrow. Sometimes the good outcomes just take a lot of perseverence. Two years after MH surgery in my ‘good eye’ and two cataract operations later plus corrective progressive glasses, am happy to report that I finally have my eyesight and independence back. Am sure you will too. Keep the faith even if you’re not religious! All good karma to you.

      • Good luck callie.
        I’ve been to see the consultant and he is going to put me on the list for cataract removal about 4 months time, he mentioned that if I still had any distortion ( which i have) removing the cataract will make this more apparant . Never even thought of that one! But the cataract has taken most if my vision from only 6 weeks after surgery with the blur the glare and the not seeing i feel to remove is my only option otherwise what was the point. Anyone else had the distortion problem made worse after cataract removal? .

      • I had the cataract procedure at the same time as the MH surgery. I had an early-stage cataract which would not normally have been considered ready for surgery. But my surgeon advised operating at the same time. He felt there was no point in making patients over 50 come back for another operation later, [not those anyway] who have early stage cataract and have virtually 100% risk of needing cataract surgery after vitrectomy. I don’t see why the cataract surgery should make any residual distortion from an impaired retina worse. It shouldn’t have any impact on the retina at all as it is in another part of the eye. But, if you leave a cataract too long, it will eventually become inoperable and you will go completely blind.

        Cataract surgery usually [worsens] glare in low light because the pupil dilates in low light beyond the diameter of the artificial lens. But cataracts start to make the natural lens opaque from the outside inwards. That means cataracts at a certain stage also create glare in low light. So if your cataract is removed at precisely that stage, you may not notice any worsening of the glare in low light.

        Anyway don’t be fobbed off. Get the cataract surgery as soon as possible. [I think] it should really have been done before or simultaneously with your vitrectomy,

      • Thank you, george00x. Yes I will be having the surgery around September. I still don’t really know what my sight is like as I acquired the cataract very quickly. I have been reading the messages on here and they are scary but comforting in equal measure. I would like the surgery sooner but I am at the mercy of the NHS.

      • Hi Callie–Thinking good thoughts for your upcoming surgery tomorrow and wishing you the very best. I will also pray for you. I sincerely wish for you a good outcome this time. I am so blessed. I had a MH in each of my eyes in January 2015. My right eye was worse that the left but both needed to be taken care of. I had 20/15 vision in each eye prior to the MH and much worse after the MH. I now have 20/40 vision in each eye and have no distortion. I will wish the same for you. Please keep us posted as you progress. As Janice said keep the faith even if you are not religious and stay positive. Blessings to you!

  84. Thanks, Lauren. When I started the MH journal back in June of 2011, I thought it would be therapy for me and if a few others read it, so much the better. I was right. The journal was helpful in my recovery. But to my surprise, the journal has by far become the most popular post in the 6 1/2 years of Long Row. Probably the most valuable content has been supplied by the comments of others who undergo this strange almagamation of high-tech eye surgery and witchcraft recovery of face-down positioning. I of course wish you the best in your up-coming surgery and hope you will get back to this site with your experience. By all means, do a journal, and, if you so want, I will plug it on this site or you can.

    • Janice,

      Thank you so much for the encouraging words. I am very happy that your surgeries worked out well and you’re able to get on with your independent life. All the best to you.



    • Had a second MH surgery yesterday, Monday, June 12, 2016. Had postoperative visit today and Dr. says the surgery went well, there are no infections. We will not know the surgical outcome until after the gas bubble dissipates and I get an OCT scan. My next postoperative visit is Tuesday, June 21, 2016. I do not expect to know if the whole closed during that visit. One noticeable change between the first and second surgery is the degree of pain. After the first surgery I did not have any need for any pain medication. But after this second surgery I am in need of Tylenol every few hours. Hopefully the pain will mean that I will gain.

      I will update as things develop. Thank you everyone for your good wishes , prayers,thoughts and support. Regards, Callie.

  85. Hi Everyone.
    glad I found this site. Like others here….pretty bummed. I am 44 years old. April 28th I noticed my eyesight was blurrier than normal. I have always had bad eyesight corrected with contact lenses. I figured my eyes were tired and removed my lenses and started checking each eye individually. Noticed the typical warped central vision in my right eye which was very new for me. (I had seen my eye doctor two months before and nothing had changed). I called them the next day and they told me to come right in. It was a stage 3 MH. Had a vitrectomy May 12th, with the gas bubble. 7 days of posturing, rented the equipment and all that. Saw the doctor on day 8 (yesterday) and he scanned the eye and showed me the pictures. Hole looks closed. Bubble is at 40% now. From what I can see above the bubble…eyesight seems worse than before the surgery. Still some distortion with letters and wavy lines. I knew before the surgery and understand that eyesight will take time and probably wont be back to baseline- I guess I just thought it would be a different type of vision change…not the distortion from before surgery. and even then…the wavy letter used to be just in the very center of my vision….but now it is the whole field of vision. He still has me dilating my eye each morning so I guess (hope) some of it is from having the pupil dilated. But it is just such an adjustment. My glasses and contact prescription is so off now. I need my glasses for distance but cant read or see close up with them on. Im constantly removing them and putting them back on. Bubble seems even tinier than yesterday – only at the very bottom of my vision now. I am an RN in an ICU. I need my vision.

    I think I am going to get a patch for a while. My left eye is fine with lenses, but both eyes together is just causing all sorts of havoc on me.

    One thing. (My doctor) he was concerned about a lack of blood coming from the vessels in my eye. It appears there is normally more bleeding during the procedure. I was actually awake during that part of the procedure and heard him discussing it with the nurses. During my follow up yesterday he mentioned he saw a slight little ischemic [lack of blood] area- so he wants to do an angiogram next week to test the blood flow to my eye. Great. Another thing to stress over!!!

    I can live with a bit of distortion. I just hope it gets a bit better than it is now and not worse.

    thank you thank you thank you for this site. It means so much to have a place to vent and compare notes.

    • Hello Jean

      First of all I am sorry to hear of your MH and can totally understand your absolute frustration and the Why ..why ..why ..
      I treat patients myself [as a] dental therepist and my God did I rage at the moon, the stars, the flowers, the trees whilst sticking on the bravest of faces and I cried at my bleak future in isolation as I live for my work it keeps me sane and gives me a value .

      Any other job except this one and it would not matter a jot, everything would be adapted to help you, but if you cannot get a line in for venopuncture or a drip, or a catheter because you cannot see!

      Oh you go ahead and vent vent vent until you have no more in you.

      Then as the cloud lifts, you will find your sensible head, the one you use at work when comforting your patients and relatives in whose hands and skill they trust.

      You are diagnosed, you have been treated very quickly, the doctor noticed the ischemia and has ordered appropriate tests. These are good things, positive things .

      Now let’s put the RN ICU head back on and have a chat with yourself. You have had major eye surgery. Just because it is keyhole does not make it any less significant.

      The one thing you will say countless times in your work, give it time. It is early days , the body has to heal.

      Be kind to yourself. Let others take care of you and keep your spirits up. Eyesight loss is devastating and takes time to process but our brains are very clever. We find a way 🙂

      • There have been so many different stories of people’s struggles with MH and as they say every outcome is different. I too have had many many problems before and after surgery. And recently after the dreaded cataract appeared after 3 weeks (I am now 7 months post surgery) I can see very little in the eye. I was told very harshly by my consultant we are not going to remove your cataract. Use your other eye. I was devastated and have asked for a second opinion. I have no idea how much vision i have. My hole was large [due to the hospital not giving] me an appointment until too late. It happened in June 2015. I saw the consultant in August and didn’t have surgery until November. By which [time] it was too late. I didn’t really take it in at first as to what it meant but a couple of weeks ago it hit hard when i went for prescription sunglasses and the hike up from my normal glasses took me by suprise. I cant cope with them. It’s like having my eyes in a tumble dryer. So i cant wear them. I came home, cried shouted, slammed doors and wore myself ou. And don’t know if I ever will come to terms with it.

      • Hello Anne

        You are in the UK the same as me. I am still waiting on surgery six months [after] diagnosis.

        I have had to give up work. I am not safe to work on patients and am fighting my own demons emotionally and financially, and I know it will ultimately affect my marriage as I know I cannot live in the middle of nowhere.

        I am married to a ex-serviceman and although “settled as such ” I have always had to drive everywhere for work and take every crappy job going to pay the bills and just as the kids are grown up and I find a great place to work and am very happy working with nice people this happens.

        Boy oh boy, do I have to keep a lid on my emotions. I have always just gone to work and come home again. Although I have professional colleagues, I have never had the chance to make friends as such so, yes, I cried bitter tears for [my] very existence. Selfish, yeah, damn right it was and I owned it every second of it.

        So I had to have a word with myself and shake myself up because my poor dear husband could not understand it and lost patience, as he could not understand how I felt.
        I do not think people have to come to terms with things or accept them , we manage them as best we can .

        If your glasses are hurting your eyes, go back to the optician and tell the so. They are skilled and clever people. Use their expertise.

        Regarding your harsh consultant, hold the arrogant excuse of a doctor to account. You have PALS to talk to. . . . If they trained in the UK , our taxes paid for that, and don’t forget that .

        My first doctor I saw could not communicate effectively with me as there was a language barrier. His boss, a female consultant, did not even acknowledge me as she came to examine me [for] another opinion. I was treated in a derogatory, dismissive manner and I thought, my God, if I was a senior citizen what chance would I have had here today. Shocking and beyond belief.

        The macular society is a brilliant organisation. They are free and you can talk to them anytime. [They are] full of information and help .

        We could join the band, rage against the machine 😎

      • Lisa, I’m like you [with] kids grown up. [I am] living in the country, unable to drive now and dependent on my husband to go anywhere. You’re right, I owned the rage and thought I will not apologise. I earnt the right. I had kept my feelings inside for so long being passed from pillar to post, being prodded and talked down to. 31 appointments to date. I did take the glasses back but they were unwilling to change them right now until after the second opinion about the cataract. I’m grateful for the operation. Twenty years ago it wouldn’t have been possible. But before the op I was promised a new lens but denied all knowledge of it. They said I would get a cataract, but by giving me a new lens it would be avoided. So essentially I’m worse off as I didn’t have a cataract in that eye but now I do.

      • Hi Anne
        I have all this to look forward to. First of all, it makes sense not to change the glasses right now as after a cataract operation your vision will change….They may have suggested some more help especially as they hurt your eyes. Glasses should help you see, not give you pain.

        You really need to speak to the hospital. NHS England Constitution is a legal framework that sets out the expectation and delivery of care.

        It has a complaints section too. There are people to help you, and your complaint has to be looked into. I used to work with NHS (dental side) and had to keep excellent notes, legally documenting my clinical decisions and also any discussion with the patients regarding this.
        All clinicians are accountable for their decisions and records. Making a complaint does not disbar you from treatment.

        If you were informed of a cataract operation and a macular hole operation to be done as one, there will be documentation and forms you had to sign saying you understood the proposed procedure, etc. and the risks involved. If it was under GA there is a legal requirement for this.

        The surgeon would also … would have had to obtain consent from you prior to your operation and given you the opportunity to ask any further questions.

        There is also a risk assessment officer that you can talk to. [You can tell the officer] you are worse off than before, that you were denied the proposed treatment, that you are now incapacitated as you cannot drive anymore. [And that all of] this is affecting your quality of life that you had prior to the treatment.

        All 31 of your operations and consultations have to be documented and signed off by the clinician as an accurate account of what took place.

        You have only 12 months after your treatment to raise a complaint about it. So 7 months post op…you need to get a jog on.

        If you gave not already spoken to the PALS, they will be listed on the hospital website. They are there to help all patients .

        That you feel frustrated with a system, cheated and angry, all are very understandable. So use the systems [set] in place by the NHS to correct this.

        I hope things get better for you soon .

  86. Good evening all. An update from me. I have a surgery date for July for MH and the surgeon gave me the option of having a new lens to save a cataract operation later. I had no hesitation in snapping up his offer. I have seen my OCT scans so am now much happier. I [now] have information and accuracy in diagnosis.

    I work a couple of days a week scrubbing up instruments whilst I can still drive.

    The outcome of stabilisation of sight is a positive one, and I am to be operated on at a more local hospital, making life a lot more manageable. I can walk five miles from home to get a bus to the town and then one from there to the hospital or [take] a taxi from the town so I can get to my appointments etc .

    I have given up job hunting for now. I guess it was my way of just doing something whilst waiting, and 15 rejections just makes you realise I have absolutely no transferable skills .

    I am going to concentrate my energy on positive thoughts for the surgeon operating and then on the challenges I will face during recovery.

    Like the song, “There will be an answer, let it be …. ”

    Callie, you go girl 🤗

    • It’s good that your surgeon offered to do the cataract surgery at the same time. Good luck for the op in July.

    • Lisa, I’m happy you finally have your MH surgery scheduled. Getting the cataract surgery out-of-the-way at the Satan time is a very smart move. I wish you all the best with this surgery. Keep us posted.



      • It is Sunday, June 19, 2016. I am six days post my second vitrectomy for MH. I get to go face up tomorrow. This is one of the few times I cannot wait for Monday to get here.

        I’ve had more pain with this surgery. After the first surgery I did not have to take any meds at all. After this surgery I was taking the maximum of six Tylenol per day. I am down to just two today. The pain is not unbearable. It’s just a throbbing kind of pain. But it is much, much better. I am hoping that old phrase no pain no gain works.

        I remove my eyepatch only when I am instilling eyedrops. A part of me wants to keep the eyepatch on until my next OCT scan. I can remember how devastated I was after my first surgery and having the gas bubble dissipate and seeing the same distorted, wavy lines and letters as before the surgery. That was my confirmation before the OCT scan showed the hole had not closed. I can still be hopeful at this time. Regards, Callie.

      • Good evening everyone. It is Tuesday, June 21, 2016, eight days post my second vitrectomy surgery for macular hole.

        I had an OCT scan today and the doctor says the macular hole is closed! I was surprised they were able to do the scan as the doctor said that the gas bubble is about 45% of my vision.

        I am very happy at this time. The last few months have been a roller coaster. The first surgery failed and I was disheartened. I was told the success rate for a second surgery was only 30% because of my high myopia. This depressed me even more. I took the chance because 30% is better than nothing, and if I did not have the surgery I would always wonder “what if”.

        Now I wait to see what my best visual acuity is. I have a follow-up in one month and we’ll go from there.

        I am really happy that I found this blog. The support and information I got here has proved invaluable.

        I wish you all the best .



      • Dear Callie, Congratulations on your successful second operation! You were very brave, and it paid off. And now your visual acuity in that eye will be the best that it could ever be. Your story will be an inspiration for those who follow this blog. Well done! Best Regards, Janice.

      • Hi Callie. That is wonderful news. I am very pleased your decision to go for the second op paid off. I hope your VA turns out well in the coming weeks and months.

        Re OCT through the gas bubble: In the past this was impossible but the latest generation of OCT lenses can handle the gas bubble with no problem. Some surgeons are now doing studies on hole closure the day after surgery. Evidence seems to suggest that the vast majority of holes that close, do so within 24 hours of surgery. This adds weight to the arguments of the non-posturing school. George

  87. Just back from follow-up 5 months after MH surgery and I am pleased to report that all still looks good. The space behind where the hole was is still filled in. My VA in the operated eye has now improved back to 20/20 uncorrected after going down to 20/25 in the weeks preceding and following the operation. There are still some blips in my central vision (slight blank spot and wavy lines) caused by the retinal impairment but I learned to live with those long ago. I hope all new patients reading this blog will have results as good as or better than mine.

    MH is impending in my other eye but has been stable over the last 3 scans, having advanced last year. So no need to consider surgery yet. Another MH and cataract surgery is probably in my medium-term future but I will be less apprehensive about it the second time around. The glare from the artificial lens implanted during cataract surgery performed simultaneously with the MH surgery is still quite noticeable but I can live with that too. Since I now have one completely clear implanted lens and one natural lens with early stage cataract, I see colour slightly differently in each eye. Due to the orange tint from the cataract I see colour as warmer in that eye and cooler in the other one. I am not going to start painting but I believe that the painter Monet had a very pronounced version of this effect after he had a cataract removed from one but not the other (because the operation was considered very risky in those days and there were no replacement lenses, only coke bottle glasses.)

    • Dictating a rambling post just to get some frustrations out. Today I am 16 days past my 2nd surgery for a macular hole in my only good eye, my right eye. The doctor confirmed on June 21 that the MH had closed. I jumped for joy, expecting my life to return to normal. However, I don’t think things will return to normal. Overall it appears the wavy lines have disappeared. I look around my house and my vertical and horizontal blinds no longer appear wavy. The pleats on my lampshades no longer appear wavy. And the grout lines in my tile do not appear wavy. These are good things, I know.

      But, there appears to be a smudge in my central vision. I know that the MH surgery is deemed a success if the hole is closed, because if it does not close I could lose all vision. It appears my only choices were no vision, or crappy vision.

      My best corrected visual acuity prior to the macular hole forming was 20/35. This allowed me to drive in the United States. My best visual acuity after the hole formed and prior to the surgery was 20/80. At that level, I could no longer drive. We Americans love our cars. Not driving and having the freedom to go to and from at my leisure has been extremely difficult to deal with. I have wonderful friends who have been taking me to work and from work into grocery stores but I hate being dependent upon others. Mentally I feel as if I am swirling down a dark vortex and I cannot to get out of it.

      I know it’s only 16 days post surgery and the eye is still healing, but I am scared and frustrated. If my left eye were good, I would feel very different. But because all of my vision is in my right eye, I just feel cheated in so many ways. I hope this too shall pass. Thanks for listening.

      • Good day everyone. It is Tuesday, July 5, 22 days post my second vitrectomy, and I am in deep despair.

        As I wrote on June 21, this second surgery did close the macular hole. However, my visual acuity is horrible. The gas bubble finally dissipated over the weekend and a half-moon grey smudge is blocking some of my central vision. I tried using my desktop computer this morning and even using a 76-point font it was very difficult reading anything. I work in a television news room where I use a computer for nine hours each day reading wire copy, emails, and reviewing video clips. I just can’t do any of those things right now efficiently. My next post-op visit with my retinal surgeon is July 22. I am scheduled to see my optometrist tomorrow in order to measure my visual acuity and to see if eyeglasses will help in anyway. I don’t think the eyeglasses will help at this time, but it’s worth a shot and I want to get my visual acuity tested to see where I currently stand.

        I opted for the second surgical attempt because I wanted the distortion to go away and for [printed words?] to be put back together again instead of in pieces. The waviness has gone away. My vertical window treatments, painted highway lines, the tile grout are all straight lines now. So how come I cannot see well? I know the point of the surgery was to close the hole so that I would not lose all vision. But not having useful vision is just as bad. I would just like for this nightmare to end.

      • Sorry about your misery. I forget, though. You had cataract surgery before the MH, right? When you said “smudge” it reminded me of my own vision before cataract surgery. From what I read, a victrectomy almost always hastens cataract formation. As you may have read in my original post of several years ago, I had cataract surgery in both eyes BEFORE the macular hole was dealt with in one eye. I had no problems and have good vision today. Wishing you the best.

      • Hey Callie
        Us independent women huh? Remember you have had success, the hole closed, reread your post, you have faith in your surgeon , your eye has had major surgery on it twice ! lines are straight can do a sobriety test now. 👍
        If you had a big tummy scar healing with stitches in it , you would not be thinking of running a marathon because your body is just going no way baby .

        The thing is you can do your emails, and use your computer, you told us so. Just not as efficiently right now …baby steps. Are you asking too much of yourself ?

        Are there computer things that make life easier to do this? Audio functions, dictate? Delegate? It [is] using a different vehicle to deliver what you want to do. An assistant ?

        I found watching football matches totally bizarre. There would be a body, no arms or legs, no head. Then it would reappear, then disappear in bits and where the hell the ball was I had no idea .

        I am sure your surgeon,one of the best remember, will be able to put things in perspective for you when you see him next. Stay strong and keep the faith. Positive thoughts Callie.

      • Lisa is right Callie. Try your best to keep the faith, although we know it is not easy. Your surgeon did a great job in closing the hole in a case you both knew would not be easy. It can take the retinal tissue quite some time to regenerate as fluid behind the closure may need to be absorbed first. But at least with the hole closed, it is not possible for any more fluid to accumulate in there. Your surgeon is in the best position to advise on what is causing the problem and how it might be resolved.

      • Good evening Longrow. You are correct. I had cataract surgery back in 2011, so this issue I’m dealing with is definitely not cataract related. The smudge looks like a half Moon in my central vision.

        I am just beyond frustrated. Have been dealing with this problem since the end of February. Macular hole was diagnosed in March, first surgery and early April and that one failed. Second surgery June 13 and the closure was successful but now I am having a myriad of issues. I do hope things work out because I don’t know what to do.

      • Ha ha ha, Lisa. Your post put a smile on my face today. Thank you for the encouraging words.

        I guess it is 53 years of frustration with my bad eyesight that is catching up with me. There are so many medical advances, but there is nothing that can help me see better. Yes, I did have a pity party.

        The company I work for has been great through all of this. I work in a fast paced environment with a lot of 20 somethings where we are reading wire copy and news copy on the computer for nine hours a day. And [that’s in] addition to watching video feeds come in. Since my eye problem developed, I have been able to do my job but not as efficiently as I have in the past. I don’t want to be the slow cog in the wheel, which is how I currently feel. There are not many adjustments that can be made to the proprietary computer programs that are used. I magnify as best I can but things are still not great.

        Things would be OK if my other eye was good but it is not. So my operated eye is the only good eye that I have and since the operation it’s not that good anymore. I will wait to see if things improve. It’s the only thing I can do at this point.

        By the way, I totally understand what you talk about when watching TV where heads disappear arms disappear. I don’t watch anymore. I have managed to finish Harry Potter books 1 through six. 😊

      • Good evening Callie

        Six Harry Potter books ..well done you and you are now showing off .😜

        So pity party I don’t think so , frustration station and held on a red light maybe .

        You will get through the day because we do , Suns set and Suns rise only sometimes we just want to scowl at the world .

        I would suggest a spin , you are in the dynamic fast paced news world after all .

        Callie the slow cog in the wheel , or Callie the brave , Callie the wise , Callie the inspirational , Callie with years of experience .

        Let the twenty somethings get on with it ,their race is not yours , run your own race , you have good support at work ,it would not happen if you were not valued .

        Colleagues would not run you about if you were this sad sack of pitiful potatoes that was a penance to lug around .

        Value you for you as others are valuing you , be kind to yourself , you have the power to choose , we all have a chamber of secrets where the darkest demons lurk and face the battle with them , so relocate that magic wand and become Dumbledor and rise like a Phoenix .

        Stay away from the dementors .

        Personally I would have dumped Harry Potter fast as I could ,way too much of a liability 😏

      • Thank you George for your comments. I know you are right. I feel like Schrodinger’s Cat [a famous illustration of a paradox, Long Row believes]. My eyesight is simultaneously horrible (my present) [and] fine (my possible future). I don’t know how to get through today and look forward to a future.

      • Lisa, you make my heart smile. 😀

        I visited my optometrist today just to see if eyeglasses could help me in this current situation. They could not. Visual acuity at 20/100. Grrrrr. Though he is not my retinal specialist, he did an OCT scan just for his curiosity at no cost to me. (I’m a medical oddity.) Looking at the scan, he says it looks good and the hole is definitely closed. He was very honest with me. He told me he had no idea how much or even if my vision would improve. He said it all depends on the cones and the rods regenerating.

        I will press on. As Hagrid says, “What’s coming will come, and we’ll meet it when it gets here.” [LONG ROW says: Not everybody reads Harry Potter. I don’t. Had to look up Hagrid, a Potter character. Half giant, half man, so I read].

      • Saw my retinal specialist today because during my Optometric exam yesterday for new eyeglasses, the optometrist noted that my pressure was very high at 35. He told me to see my retinal specialist as soon as possible.

        Got an additional prescription to hopefully lower the eye pressure. And during visual acuity test I am still reading 20/200 out of my good eye, the operated eye. So, as of today I am officially legally blind. The retinal specialist talked with me about applying for disability. This hit me like a sledgehammer.

        I work for a wonderful company and my job is safe until the first week of August. I either have to return to work by that time with approval from the surgeon stating that I can’t perform my duties with reasonable accommodations, or I will lose my position.

        A part of me regrets opting for the second surgery. However, I just don’t think there is anyway that I could not go for it. So I have to let that regret go.

        I see my retinal surgeon on Friday, July 22, 2016. Please send prayers and good thoughts that my vision gets better over the next couple of weeks.



      • We are all praying for you Callie and hoping your VA will improve soon. I am sure all of us would have taken the same chance as you did to have the second operation with an excellent surgeon.

      • Hi Callie

        I am a bit confused interpreting your post. You had a reading of 20/100 VA by your optometrist who noted high ocular pressure and referred you. Your retinal specialist gives a reading of 20/200 but you said you are still reading 20/200? And he has declared you legally blind? Medicine given to lower ocular pressure (which from my anatomy days is [due to] a build up of aqueous fluid? That can be controlled? These are 2 different readings by two different people in a 24 HR period. Is there a typo or a discrepancy between the two readings? Then you see your retinal surgeon on 22 July. Is this a different person from the retinal specialist ?

        My thoughts are with you . . .positive energy,Callie. There are plenty of jobs over here as all our cry baby politicians are resigning, and we will have a female prime minister again. I am tempted to write the Brexit exit strategy myself.

      • Hi Lisa. Some clarifications for you. Sorry about the confusion.

        1. The visual acuity reading was 20/200 at both the optometrist and the retinal specialist. I use Siri dictation for these posts and I try to go back and make corrections for things that she doesn’t quite get. [The] 20/100 was a typo.

        2. The retinal specialist I saw yesterday is not the surgeon who performed the second surgery. I could not get into see him on such short notice so I went back to my retinal specialist, the specialist who performed the first surgery.

        3. The retinal specialist gave me a prescription for dorzolamide timolol to control the eye pressure. I will see him next week just to have the eye pressure tested to make sure it’s under control.

        4. The retinal surgeon I see on July 22 is the one who performed the second surgery and successfully closed the hole.

        5. He told me for all intents and purposes at this moment I am legally blind. He even told me if I wanted to get disability paperwork started he would be willing to do that. However, I asked him is this it and he said, no, [it] is still healing. So, I don’t expect to remain in this state.

        6. I am going to fight to keep my employment. I have an appointment at a low vision clinic next week. I hope to obtain visual aids that will help me through this rough patch. In order for me to return to work, I [need] my retinal surgeon to certify that I can do so with “reasonable accommodations.” As my vision improves I will no longer need these reasonable accommodations and life will go on. 😊😊

        Hearing legally blind was distressing, but my friends talked me off the cliff. This is just a point in time, it will get better.

      • Hey Callie
        Thanks for clearing that up, and you have good friends there to help you. I would take anything going to help you in your job. Don’t do the “I can manage with just this or that.” Get the biggest magnifying screens ever, a bigger desk , a bigger chair. It is a one-time supermarket sweep. Then run a story on low vision or do a charity day raising awareness of low vision. Be a voice for it. You have been with the company awhile, [so] is there a sideways move you can take to make life easier and more manageable for you?

        I am in the gas-bubble club now having had my surgery today, and during the procedure I heard this snort, and then I got asked if I was ok (I was under local anesthesia) The surgeon [was] concerned I was having breathing difficulties. No, I said, I think I had started to snore!! Well what do you expect, lying me down on a comfy bed [with] music , drapes over my eyes. Don’t ask me how I zoned out .

        So my journey really begins today.Thank you to everyone that posts their experiences. It is a place of comfort and humanity .

      • Great advice Lisa. Best of luck with your own recovery. I had a slightly less amusing moment in my surgery when the anesthetic started to wear off. Luckily the surgeon noticed me wince before I could say anything and quickly dealt with it with another shot.

    • Good day, George. So glad you’re fine [your five?] month follow-up went very well. The vitrectomy worked out for you and that is fantastic news. Your future outlook is very promising. And your attitude is wonderful. Please keep us updated as your journey continues.

      • Thanks Callie. I do hope the vision in your operated eye improves significantly with time. If it was deep, it may be a case of new tissue needing to regenerate in the retinal layers behind the closed hole. If so, it can take many months. All good wishes for a good recovery.

    • Lisa, you had your surgery today!? You are now a member of the GAS BUBBLE GANG😊 I’m going to pray for a full and speedy recovery for you. Everything will be just perfect. Please keep everyone posted on your recovery. I enjoyed your witty writing style. Yes, during my surgery there was a point where I was completely out and then I woke up and I could hear the doctors and everyone talking. Nice to know you were comfortable enough to fall asleep and snore. You go girl. Best to you and I look forward to reading about your recovery.

  88. Have found this blog which I can relate to. Had left eye MH surgery in April and right eye MH surgery mid June this year. Still in recovery from both surgeries. Would like to join blog to share sometimes the difficult journey physical and emotionally this surgery throws at you. And also how it helps to read other people’s experience. I admire and thank retinal surgeons for the knowledge and skill that they have to be able to offer this very delicate and complicated surgery.

    • Good day Anne M. You will find lots of support and first person stories on this blog, thanks to Long Row. Everyone has a different story but most people come through with flying colors. I hope you too are one of the lucky ones. I had macular hole surgery on my right eye in April. Unfortunately, the hole did not close. I had a second surgery on June 13, and this time the hole did close (yay!!). My recovery phase has gone sideways, but I know things will improve.

  89. An update. Well, eye surgery, how amazing is it? So very very clever and delicate. I would loved to have been a fly on a wall when the original surgeon had the idea equivalent of a pea shooter stuck in your eyes and fine instruments inserted etc. I am 5 days after vitrectomy and cataract surgery. I am very well [with] slight discomfort,no pain. I have my gas-bubble friend that totally blocks my vision. I would say [it’s] worse than underwater although I can see shades of light and dark, So [it and] my new bionic lens will have to meet in good time.

    As Long Row says it is all about closing the hole. I will know in three weeks when my next appointment is. I have only had to sleep on my side for 5 days, so I managed that by moving into a single bed vacated by my son and using pillows etc. The top of my arms ache but I think this is down to my weight being turned onto them.

    Tomorrow I am going to try and ride my lovely bicycle, [the] one I brought back from my workplace. It has a basket and panniers so I am going to be Keira Knightley, the actress with an eye patch shooting a movie scene.
    If all goes well, I will become Sir Walter Raleigh conquering new lands as a coffee shop is located ten miles away, and [if] I get there safely on flat country, minimal traffic roads. So apart from all that, I am totally BORED to the heavens and save up things to do to break up my day. The only happy person is the dog who gets a very very long walk .

    • Lisa, thanks for the update. Wishing you a fantastic surgical outcome. You did not have to do face-down positioning? Lucky girl. Please be safe on your bike ride. 10 miles is a long way to go for a cup of Joe. 🙂

      • Hi Callie, no face down at all. Just don’t sleep on my back day or night for 5 days. I will be careful on my bike. I am not allowed to drive at all with [my] gas bubble friend until he has gone totally, so I will comply. I want the best outcome there can be as we all do. I am going to start off slowly and if feel confident then continue. I think it is my way of occupying my time. It gives me something to do and markers to hit. [It is] my way of breaking out I guess and giving me something to do that is constructive. There are shops there too, a butcher’s and a mini supermarket so I can do the hunter gatherer thing.

        I am unable to work anymore in my profession. We have a saying, “If in doubt, do yourself a favour and walk away.” I won’t be able to see the millimetre graduation marks on a periodontal probe. Or what if I missed that tiny break of tissue or red spot in your mouth that was cancerous and I then condemn you to a death sentence because I cannot do a soft tissue examination properly? I will grieve about the loss of the profession, as it is what has defined me for many, many years and I worked hard to get there. But at the end of the day, it is only teeth. I will have to change direction and put my energy into something else and move on.

    • Lisa, I hope and pray that you have a full recovery🙏🏼. Don’t give up on returning to work just yet. You don’t know your outcome. Things may end up being spectacular. I was extremely depressed at the prospect of not being able to work any longer. I felt defined by my job. And I was crying because I’ve been doing this for 32 years, longer than the 18 years that I had my mom in my life. It was pretty bad there for a while. But I am turning the corner.

  90. Callie, thank you for your reply, and [I] hope the vision in your eye improves. My recent surgery on my right eye was carried out on 17th June. It was more complicated compared to my other eye which was operated on in April as there were a couple of more worrying retinal tears near the nasal area of the retina and I had to lie on my right side for 7 days to allow the gas bubble to press on [the] affected area. This was no problem as I decided I would carry out instructions to a tee to hopefully achieve best outcome. Consultant also used longer-acting gas bubble. Still probably have another week or two with bubble. Can now see over top of bubble [and] can see objects in the distance. Seems ok, but reading is still fuzzy. Hoping this will improve in time and thankfully my other eye has improved over last 10 weeks. So all in all not bad. The only other thing [is] the 2 surgeries have left me with some peripheral visual flickery thing, almost like steam rising. Not aware of it all the time, and if I wear glasses, the frame tends to help blot it out. I asked the consultant about it and he advised me it was due to the tears I have in both eyes at the nasal area. I was glad [for] an explanation because as long as I had an explanation I can accept the situation. I now just refer to this as my ‘busy eyes.’ This is unlikely to go away, but as my peripheral vision is ok, my brain over time will over-ride these images. I have appt 26th July with Consultant, and hopefully OCT scan will show MH in right eye closed.

    • Anne M, so sorry you had to go through this twice. Sounds like you have a good consultant. Having an explanation for something is always better than not knowing. Because when you don’t know, your brain goes into overdrive with other scenarios. I am praying and hoping that you’re 26 July OCT scan shows that your macular hole has closed. 🙏🏼
      I am curious, how is the vision in your left eye 10 weeks post surgery? I am four weeks and two days post of my 13 June surgery.

  91. Hi Callie, I am now 13 weeks post op with my left eye, and I am really pleased with the progress. Initially when I started to see above the bubble I could see clear but straight lines [that] were very wavy. For example, houses looked crooked, and writing especially ticker tape writing on TV was very wavy.

    However over last 8 to 10 weeks this has improved, and there is only a very slight wave. Thankfully I am able to read with my left eye. Distance vision remains clear,so I am very grateful. I am 4 weeks post op tomorrow with right eye and bubble level is about one-third [remaining]. But [I am] not seeing as well with this eye. Reading not easy and everything duller and a little hazy. However it’s still early days! Consultant did say at initial consultation that recovery from this surgery can take up to 9 months. I have great faith in the Consultants. I know all that can be done has been done. Hoping to get back to driving once bubble disperses. Glad now I can read road signs and registration plates clearly. My only regret is I am still not sure whether my eyes will be good enough to go back to work. I am a District Nurse,retired 3 years ago at 60, but joined the nurse bank and have worked 2 or 3 mornings a week which I just love. However [I] need to wait another 4 weeks before I know for definite whether working is an option. If not, I have been lucky to have nursed for 44 years, and I will look to maybe do voluntary work, possibly local hospice. The only other thing that has happened with both surgeries is I have had loads of black debris. Consultant also reassured me this was normal. He couldn’t say whether this would go away but said it would likely fade and be more shadowy. He was right. [I] can hardly see the debris in the left eye now, but have loads in the right eye, almost like a curtain. Funny, though, it doesnt bother me too much. I think again the brain overides what you are seeing at times, and you are not so aware of it until you stop and think about it. Hope you and Lisa’s post op recovery goes well. It is good to have support from other people who have gone through similar experiences. Take care.

    • Anne M, thank you very much for the update. I hope and pray you are able to return to nursing, a career you so love. It sounds like you are doing very well. Reading road signs and registration plates is fantastic! Kudos to you. I’m very happy [the black debris] has faded and that you hardly notice it anymore. The brain is an amazing organ. I return tomorrow for a third post op visit. My recovery kind of went sideways. But, I am hopeful. 🙏🏼 I wish you all the best. Take care of yourself.

  92. Callie, thinking of you and hoping your return appt went better than you were thinking. I go this Tuesday 26th for my next appt, looking forward to getting OCT scan as I am not so sure hole is closed. Still have some gas bubble in right eye and above the bubble, sight duller and a little hazy. I can read large print but normal font i.e. newspapers, have some distortion in the middle of words. I know it is still early days and [am] lucky I can see. Thankfully left eye continues to work well. Will keep you posted. Take care to everyone going or gone through eye surgery.

    • Anne M, congratulations on the successful closure of your macular hole. That is good news. And you’re able to read already! That is fantastic. What I wouldn’t give to be in your position.

      I saw my retinal surgeon Friday, July 22. He performed a slit-lamp exam only. Visual acuity was measured at 20/100. This is better than my last test on July 7, which measured 20/200. However, this is still very bad. Specialist says there is no fluid behind the closure, but I have chorioretinal scarring [an area of pigmentation change or fibrosis] for which nothing can be done. When I asked what he believes my final visual outcome would be, he said we have to wait and see. He could not offer any guarantees that it would improve. I know surgeons can’t guarantee specific outcomes, but I am extremely disappointed. I took the chance on the second surgery to close the hole in hopes of a positive outcome. That has not been my case. I went from bad (20/80 and very wavy) to worse (20/100 and not wavy). I honestly don’t know how I am going to move forward. I just want this to end.

      • Callie, sorry to hear how you are feeling, but hoping over time your eyesight will improve. I can read but only with my left eye which was operated on in April. My right-eye vision still is hazy and when reading with this eye only, words [are] not clear, middle letters of words have a blip in them. It is wait and see for improvement. Had a bad day today with outer peripheral light flicker [in] both eyes, worse than normal. [Was?] distracted despite trying to keep busy, wondering if it was due to all the eye examinations yesterday including bright lights from OCT scan. Keeping fingers crossed it improves tomorrow. Thinking of you Callie, and keep up your good spirits. They say it is good to talk and if this helps, keep doing it.

  93. Just saw Consultant and had OCT scan. MH closed both eyes, good news. However have a few retinal tears that have left scarring. This is what is causing visual flickering at periphery [of] both eyes. Can live with that. Still some distortion in right eye when reading. Consultant was saying the evidence now is pointing to a 2-year period for vision to improve fully after MH surgery. Still have some gas bubble left in right eye. Should go [away] in next 2 weeks. Hip hip horray. Can then get back to normal activity (swimming}. Next appt 3 weeks time. Hope Callie and Lisa are well. Take care.

    • Anne, Glad to hear you are doing well. Having MH surgery in both eyes in fairly quick succession must be a bit of an ordeal. I have impending MH in the unoperated eye too but not close to full thickness yet, so need for surgery. Every eye is different. My surgeon’s reason for saying that vision could take up to 2 years to recover as much as it’s going to seemed to be because there was initially still a gap in the layers of retinal tissue behind the closed [portion] almost to the very back of the retina which was probably full of fluid. These gaps can be of varying size and thickness and can take up to 2 years to fill out as much as they are going to, as fluid is absorbed and new retinal tissue is generated. I believe that the quality of the new retinal tissue can vary and may or may not be the right cells for the layer of retina or just generic retinal tissue. Sometimes the old tissue is just pushed aside by a small hole that has not been there long and may fall back into place when it is closed which would probably provide the best results. Some patients may not have much of a gap at all, if their MH was very shallow and had not been long in formation. In my case the gap was very deep and been forming for two years but surprisingly filled out in a couple of months [rather than two years]. So I guess my vision has already improved as much as it will which is not bad at all.

      In addition to the gap, if one is present, scar tissue where the hole is likely to improve somewhat, just like a scar in the skin, but will be permanent. I guess retinal tears would be the same. I still have more or less the same wavy lines as before surgery but I already had them for 15 years before MH. It was diagnosed as a result of cellophane maculopathy [retina wrinkle], caused by the same vitreous tugging on the retina that later caused the MH. Since it was present for a long time before the MH I guess it is permanent. I also still have a slight gap in central vision probably where the scar is, like the one described by Long Row. Like him, I can usually work around that. I also had debris or floaters in the form of black spots in my central vision and some hair-like floaters in my peripheral vision in the weeks after surgery. All seem to have gone now, except one tiny black spot in my central vision which I assume is now here to stay. BTW [by the way] I was told to refrain from swimming for 6 weeks to avoid infection but I was also given antibiotic drops for 6 weeks which might have been overcautious.

      All the best for your recovery and I really hope you will be able to get back to work again soon. Also best wishes to Callie and Lisa.

      • Sharing Emotions Helps

        Hi, George. Thanks for your good wishes. It has been quite an ordeal since last October when I was diagnosed with macular traction in both eyes. MH developed very quickly by December in my left eye. Two weeks before my surgery in April, MH developed in right eye. I am one of the unlucky ones! In a way I am glad surgery was done within 4 months but in another way it was hard. I am a positive person and probably look on the bright side. However this shared blog allows you to share and sometimes say how you feel as other people have gone through similar experiences. It does help. When was your first surgery? It sounds as though you have had a good outcome. Keep in touch about the plan for your other eye.

  94. Good evening everyone and thank you all for your good wishes. So…post operation follow up, Macular hole is closed so total success. [It is] all about the hole and nothing else. Discharged from hospital, surgeon has done his job so to speak. Vision [was] not measured. It won’t be for a few weeks. Y just get an eye test and say the lowest line you can see. Bit weird really and pretty inaccurate in my opinion. All my eye tests at the hospital have had the chart at different distances and different-sized letters. I can exercise normally [and] drive when gas bubble [is] gone. Have made an appointment to [get] my new prescription.

    Well what can I see? A big bold letter E all joined up on a white background, a water level in my eye, lots of black flies (this [is] parts of my eye, natural lens, [etc], I guess. It is like looking through a very dirty windscreen whilst seeing water rise. I can make out faces although these are blurred like looking through fog. I can see shapes and make out what they are. Sunlight hurts my eye, so always [wear] sunglasses, even indoors if bright. No pain, still on drops for another few weeks although reduced now. So everything else is a bonus. Hopefully I might [soon] see the damn kerbs I stumble over.

    Callie, where you gone girl? Thank you for your prayers and wishes. My profession may still be open to me but I am really not sure I want the responsibility of it anymore. It is still an option provided I can get indemnity insurance. It will be the optician who tells me if my sight can deal with it medically.

    A lot of emotions. . . . Although I know macular holes are random, [I wonder]: Did I do this to myself by constantly having to work to fine detail for long hours and take any work that came along even if the surgery was a dingy cupboard hole and light was poor? But I needed to earn the money. Is this a life sign? A shot across the bow of the boat that could be patched up? But maybe not next one? Too much time on my hands thinking . Need to find a life out there somewhere as I was always driving long distances for work So that has to change and there is only me that can do that. Hole closed, excellent work, doctor xx. I can treat myself to some new makeup as I am allowed to wear it now. 😘

    • Worries About Returning to Work

      Hi, Lisa. Totally relate to your post, especially about the emotions while going through all this. It feels life changing. Like you, [I wonder if] going back to work is possible? I don’t know at the moment, but keep my fingers crossed as I absolutely love my job. For months now life as I know it has had uncertainty. However I now think of half full cup and [keep] fingers crossed. Will be thinking of you and a good outcome. Glad you are at the stage of putting on make up again. Will look forward to that soon!

    • Aging, Not Eye Strain, Is The Problem

      Lisa, I hope your recovery goes well and your vision improves when the gas has gone. No you didn’t do it to yourself. All the evidence points to MH being caused purely by the vitreous tugging on the retina as it dries out with age. Nothing you could do with your eyes would make the vitreous dry out or tug at a faster or slower rate. It’s just age and the luck of the draw.

  95. Anne, I am unsure of what the consultant told you re the “2-year-period.” Is the consultant saying your vision will recover fully after that period with no scarring? Or saying your vision will improve as much as possible in two years WITH some scarring?

  96. Hi, Long Row. Sorry, realise my last post misled the reader. My vision will never be back to what it was before surgery but will continue to improve to the best it can be over 2 year period. I will always have scarring on retina. Initially another Consultant advised recovery period would be 9 months, but the Consultant I saw yesterday said there is new evidence pointing to a 2 year period. I had MH surgery on my left eye in April and the acuity in this eye has improved again over last 6 weeks which I am very pleased about. Hope this info is’clearer’.

    • Thanks, Anne, for clearing that up. I thought that was the case, but just wanted to make sure there was no miraculously new procedure that erased scars. So it remains true. Once a scar, always a scar.

      • Hi, Long Row. How wonderful it would be if having no scarring would be a possibility. However am very grateful that MH surgery can be offered to you now, as it is not that long ago when there was not such an op. Again very grateful for the knowledge and skills of retinal surgeons. Thanks for your responses.

      • Praise for OCT Photography

        Sorry to hear about the problems caused by the scarring, Anne. I hope you will still get some improvements in VA [Visual Acuity] as things settle down over the coming months. We also have to thank the scientists who have devised and improved OCT photography, without which the improvements in MH surgery would not have been possible. They could only see the see the surface of the retina before, not the layers behind it.

  97. Optic Nerve Damaged by MH Surgery?

    It has been a while for an update from me. I went to my optometrist since I am back home in Ohio after returning from Florida. She says it’s time for me to think about having my cataract removed. It has been eight months since my MH surgery. The macular hole is still closed, but my peripheral vision is gone and I still have a black hole in the center of my vision. I am experiencing much pain in my eye, mostly along my eyebrow and along my orbital bone and upon eye movement at times. I have developed blood in my eye on several occasions which takes weeks to dissolve. I just returned from a visit with a retinal specialist and they found a retinal tear in my right (good) eye. I underwent laser surgery for approximately an hour and will return in a few weeks to see if the “welding” of my tear is holding. This latest retinal specialist says that my optic nerve was damaged during my MH surgery, either by the way the gas bubble was inserted or by inserting the gas too quickly. It was all so shocking, and I know I will have more questions for him when I return. I am assuming this eye pain is caused from the optic nerve damage and thinking after almost 8 months since surgery that this pain will never go away. I wonder about the future. Will I lose my eye entirely? Will I lose even more vision? I read your posts and think how fortunate you all have been. I guess I am the 5% that does not have a good outcome. I will post after my cataract surgery (if I get up enough nerve to have it done). I would appreciate being lifted up in your thoughts and prayers.

  98. Second Opinion?

    Alice, thanks for sharing. I hope you get a second opinion on what caused damage to the optic nerve. If it is true the MH surgeon was at fault, an attorney may help you resolve the legal issue of malpractice and bring about a financial settlement. You should not have to go though life with this kind of pain. Please write back as your situation progresses. I hope too that your problems will not deter others from saving their eyesight with MH surgery. I believe yours is the first case of nerve damage that has been posted on Long Row. Readers should understand no operation is perfectly safe, but the odds in this case seem to suggest MH surgery is still by far the best option to save one’s eyesight..

    • Had similar pain

      Alice, don’t give up hope, I too had the same pain as you after MH surgery 10 months 2 weeks ago, and the pain in the area you describe was horrible. It was always made worse when dilating drops were used for check ups, etc. It [is] just starting to settle down. I have just two days ago had my cataract removed so am in healing mode and hoping all goes well. Will pray for you too.

    • Surgical Error

      Thank you all for your thoughts. It is appreciated. I had my second appointment with the new opthamalogist as a follow up to my laser surgery on my good eye. He said it looks great. My vision in that eye is the same as before the surgery so I deem that very successful! I asked him more questions in regards to my left eye where I had the vitrectomy for my macular hole. He said he has never had a patient lose peripheral vision, and he has never had a patient end up with a black hole in the center of their vision. He said he was so very sorry it happened to me and that it should never have happened. He stated he would put in his records that my retina and optic nerve were damaged and was the result of surgical error. I have filed a complaint with the state medical board and they have asked me for release of records. So we will see what they do. I still experience pain along my eyebrow and orbital bone, and it still feels like something is in my eye. I was told to try Systane drops four times a day for the dryness and perhaps that will go away. As far as the orbital bone pain he has no idea other than it could be a phantom situation where the optic nerve was damaged but I can still feel it. He explained it like someone who loses a limb and they still feel like it is there, if that makes any sense. I am trying to not stress about it and accept the things I cannot change. Fortunately I am blessed with a wonderful supporting husband and family who allow me to vent, cry on occasion. My next step is removal of my cataract that was formed after my surgery. I will see the specialist in September to schedule that. Stay tuned!! Again thanks!

  99. Encouragement

    Hello, Alice. No, no, no. This is just not acceptable that you have been in pain for 8 months and lost peripheral vision? They say an MH loses central vision and you retain peripheral vision . . . . Did you not go back and drag him over the desk and say, “What the hell is going on?” And the retinal surgeon goes, “OK, honey, the gas bubble caused that. Let’s move on and do the cataract surgery now.” You are now blind in one eye? I accept there are risks. We sign the consent forms, but no surgeon does an operation without thinking they are not going to help their patient. . . . I am saddened to hear of your suffering in pain and loss of vision. I will do my very best to transport uplifting thoughts to you. Have courage Alice, meet your challenge head on.

    Callie, honey, take the count as boxers say. Rest a while. . . . Sometimes we just have to stop a while and just be. Accepting this is tough, but we would be the first to give good old advice to anyone healing. We have had surgery. We need to heal. You have had double trouble. And also we are older. Our heads say 21, our bodies say different. So, Callie, I am sending you positive energy across the waves [from the UK]. Every mountain is reachable. One step at a time. . . .

    George, I love you to bits. All your knowledge, and I love the fact I just got called old. So I can now be cantankerous and shout at the young people. Excellent stuff!!

    Annie M, keep going. Excellent news 😍.

  100. “A beautiful world out there”

    Hi again, georgeoox or gorgeous george as i think of you. I’m back again, have just two days ago had my cataract removed in my MH eye. It got so bad [that] I couldn’t see anything [and] I had to go back to my surgeon who dealt with the MH. . . . I can see some things. Obviously nothing central. But, oh my god, it’s a beautiful world out there. Keeping fingers crossed everything heals well. I have some flickering light, top left, but it seems this can be caused by the implant. Will see the surgeon next week. I am on very painful drops to keep the pressure down as I am a steroid responder [One in three people are said to likely be a responder, facing added eye pressure due to steroid treatment.] I’ve been told 7 weeks healing time due to previous surgery. Nothing [has] been mentioned yet about other cataract in right eye. It seems you have to be unable to read more than three lines on the eye chart. I would have thought that didn’t apply if you had to rely on that eye.

    • “Stick with it”

      Hello, Annie B. Really good to hear that you have now got somewhere with your treatment and things are resolving. It is a very frustrating process, and I am pleased things are falling into place. Painful drops [are] stinging little critters but the end will justify the means as they say. There is always a trade off. Stick with it. You have been magnificent so far and you can see things again 😌. Healing thoughts and positive energy.

    • Concern over ‘flickery light’

      Hi, Anne B. It is a beautiful world out there made better today as sun is out. [That is] wonderful,quite rare in Scotland! Interested to read your post. You will be glad to have cataract surgery. I also had lens implant at same time as MH surgery. I have flickering light [in] outer aspect, both eyes. Had MH surgery both eyes April and June this year. Also wondered if [the flickering] had anything to with light reflection at outer edge of implant. When I spoke to Consultant he advised this flickery light was due to retinal tears that are present at nasal area. He used cryocautery [freezing] on these tears to seal them, but of course there is scar tissue left. Might still be due to lens. I use glasses (either sunglasses or those with plain glass) as the frame helps to blot out this annoying light. Please keep in touch as I am interested to know if flickery light improves over time. Good luck with recovery from recent surgery.

  101. Riding a bike in the interim

    I still cannot see very much with my operated eye. But strangely enough, I am not worried about it (yet). I saw my scans and know all is well in the closure department, and I have a feeling they super-glued the gas bubble to make sure! I tried riding my bike for my cup of joe [coffee]. [It] gave me something to do. I was a lot wobbly at first but then [put the] eye patch on, and away I went. Much easier. Then the heavens opened [rain?] and I thought [it] time to turn around because this is not going to be fun. I always said to my family, if I had the chance to take six weeks off, I would get some weight off that has been hanging about a few years now (far too busy working to exercise meaningfully). And darn it the men folk remembered. Careful what you wish for 😱. Life just got a whole lot tougher but in a good way as it will be better for my eyes, and being on antibiotic drops for six weeks means no alcohol anyway as it dehydrates your eyes. Positive thoughts people. xx

    • The European 6/x system

      Hi, Lisa. Thank you for your healing thoughts. I always thought MH was quite rare but the amount of people going through it disputes that! Since the cataract surgery on Wednesday I have found that although the nurse said my cataract in the right eye isn’t ready to be done yet, it has shown up the blurriness more. They have me down as 6/4 on the eye chart for that eye but not sure what that means. My left eye was 6/36 before cataract surgery. [LONG ROW: As I understand it, VA in Europe is measured by the 6/x system, which is comparable to the 20/20 expression used in the U.S. The “6” stands for meters, the distance a person with normal “6/6” vision can read the eye chart. The “x” is the distance you need to stand to read the same chart. Your “6/36” means that what you can read at 6 meters is what a person with normal vision could read at 36 meters. In other words, that is bad VA. Your 6/4 reading is excellent. If anyone can explain it better, please do.]

  102. More on ‘flickering’ light

    Hi Anne M. I also have something that could be described as flickering light in my peripheral vision following combined MH and cataract surgery. It is not very bad and I had thought of it as a sort of mild fluttering. I asked the surgeon about it when I still had the gas bubble and he said it was too early to say and we should let the eye settle down. Although it hasn’t gone away completely, it has diminished in frequency and intensity since then and foolishly I haven’t asked about it again. I don’t have retinal tears, as far as I know, so it is unlikely to be due to that in my case. I also have the sense that the fluttering is to do with light scattering at the peripheries of the implanted lens but I could be wrong and your eye may be different.

    • Flickering went away

      I also had the exact same sensation of light scattering at the peripheries of my newly-implanted toric lens [torics are used for astigmatism] as well as a feeling that my eyeball was ‘twitching.’ However, after several weeks both these sensations disappeared and I have had no further problems. Often it takes quite a while for the eye to settle down, so it is good to be patient as the eventual outcome is often better than we had ever expected.

      • Janice, I can relate to the feeling of the eyeball twitching at the same time as light flickering at the peripheries. I wondered if it was blood pulsating in the eyeball but I haven’t noticed the feeling for some weeks now. I hope it has gone completely and that Anne’s similar symptoms will also disappear or diminish in time.

      • Patience considered

        Hi, Janice. Thanks for your response. You’re right about being patient. My Consultant has already said that recovery from op can be anything from 9 months to 2 years to achieve best possible vision. By then this flickering may improve or go away altogether. Just going into my 5 months post op with 1st MH and only 6 weeks for 2nd MH surgery. So it is wait and see. Don’t know what lenses are used here, but can ask at next appt? Also good to share any concerns. Thanks

    • More flickering

      Hi, George. I first had [flickering] when the gas bubble was there, and like you it varies in intensity. After my appt last week — possibly due to pupils being dilated and OCT scan flash light — it was particularly bad for 36 hours. Very annoying. It has settled down, but I am still aware of it at times. Sometimes I think your brain just gets used to it and when you’re busy the distraction helps. As I said in previous post, I wear glasses as the frame seems to blot it out a bit. [While] helpful, it does mean I am constantly wearing glasses. I don’t need distance-only [glasses] for reading, so I got my optician to make up a pair with plain glass which I can use indoors as I don’t always want to rely on sunglasses. I will speak to Consultant again about this when I go back 15th Aug. Will keep you posted.

      • Almost back to normal

        Hi, all, thinking of you all and hope you are all well. Went back to see Consultant today,was relieved to see him for advise. Bubble eventually went [away] last Friday,8 weeks post op. However I felt my ‘eyeball’ has been feeling heavy and I was worried the pressure was up. However Consultant said pressure in both eyes is normal,so don’t know what is causing this feeling. Hopefully over time it will improve. Still having peripheral flickery light [in]:both eyes but it is less frequent and less intense. So [it is] becoming easier to ignore. Still need to wear glasses which I don’t need for distance. If I don’t wear them, I feel a bit off.
        Consultant says it probably helps to filter out the peripheral anomalies, small price to pay to be able to see. Also got my confidence back to drive. Don’t think at the moment I will be able to go back to work and I am sorry about that, mainly because I find my eyesight seems to be not so good when I am under any stress or tired, and by gosh your eyes tire quicker after this surgery. Again patience. There is a recovery period where the brain has to readjust to new eyesight. Past few months have been a steep learning curve and I am very grateful Long Row for this blog. It has been really helpful sharing and reading other people’s experiences. I have been discharged today and Consultant did say any further concerns to get in touch through my otician. His parting words were going and enjoy life.

  103. An Unexpected Surgery
    Hi all, thought all was ok, but here we go again as the song says. I am to be readmitted today for surgery tomorrow for slight retinal detachment at inferior lower part of retina on my right eye. [Same eye I] had mac hole surgery in June this year. Thankfully the ophthalmologist says they have got it early so fingers crossed. Managed to have a lovely 2 week holiday, which was needed after the 2 previous surgeries, but during the 2nd week of the holiday started to notice a shadow very high up in my perpheral vision when I wakened in the morning. It disappeared when I got up. But I started to notice a ray of light in same region when I closed my eyes. Sometimes I don’t see it when it is dark. So went to optician on Friday afternoon to get it checked out. [She sent me] to local hospital. They then contacted my retinal specialis. I have to go today for probable surgery tomorrow. I’m a bit fustrated as I was just back getting on with life. Thank goodness for a wonderful patient husband,family and friends. Hope everyone else is doing ok.

  104. Still Debris in Eye

    It’s been a while. I am very well. My gas bubble disappeared after 6 weeks and I was cleared to drive etc. Hole closed surgically. So what happens now? Optician exam, prescription. Just about the same as previous so no change in glasses etc. New lens all good. Happy days

    So here is the trade off in my case. I still have a lot of debris in my eye. I think it is connective tissue or lens tissue from my own lens removal. It is like a tadpole moving around. Most of the time my brain over-rides this when I am busy. Mornings my eye is blurry and takes a few mins to focus. Reading-wise I can see black on white letters clearly if large, faces are not blurred on the left side anymore. Football matches(on tv), I see the bodies now but the heads do disappear now and then. Night driving a struggle, after 40 mins lots of glare and dents my confidence.

    Work-wise, profession not followed (I was a dental therapist). I cannot see graduations on some of my instruments. I have had three months off work and managed to get a temporary job as a dental nurse. It has been my first week of this, and it has been a challenge to say the least. But, hey, someone gave me a door opening. I make mistakes, and my brain has just melted. I question myself did I actually possess this knowledge dentally years ago? It is learning curve as the agency says. I will stick it out till the end 3 months, learn everything I can, and get the reference .

  105. Recovered well

    I am 11 weeks post surgery and have recovered well. Gas bubble went 2 weeks ago, hung about a bit. I am back driving, and am job hunting at present. I am unable to continue as a dental therapist as I have a lot f debris in my eye still. It looks like a chewed up sticky sweet or a dead mini spider. My brain ignores it most of the time.

  106. Thrilled

    I am just back from the doctor after my one week follow up after macular hole surgery and one week of facedown time. I am thrilled that the hole has closed and all is well. I had scoured the Internet for information on individual experiences with the procedure. Yours is by far the the most sane and helpful posting I found. Thank you so very much.

    • ‘Secondary cataract’ problem fixed

      Great to hear that, Lynn. I hope you continue to make a good recovery. All the best to you too, Anne. I had a little worry recently that was fortunately resolved yesterday by my surgeon on a routine follow up visit. The visual acuity in my operated eye suddenly started deteriorating again about a month ago, and I was having difficulty reading the newspaper, road signs, etc. And, having been lucky to have a fairly speedy recovery from the macular hole surgery with pretty good vision, it seemed quite a bit worse than just before the surgery.

      It turned that I had a condition known as posterior ocular capsule opacity. [It] was a complication of the cataract surgery I had simultaneously with the macular hole surgery. In cataract surgery they try to preserve the sac that the natural lens sits in and use it to seat the artificial lens and prevent it dropping down onto the retina. However, this capsule can cloud over similarly to the formation of a cataract and the process can be accelerated by the gas injected during vitrectomy. This is exactly what had happened to me. Luckily it can be dealt with by using a laser to make an opening in the back of the sac that lets light in normally again. The procedure took about 5 mins and was painless, albeit rather uncomfortable with a contact lens pressed into my eyeball. When I left the hospital I could hardly see anything through the eye. The cloudiness had got a lot worse but over the course of a few hours the vision cleared up and I was able to read car number plates and read the newspaper again.

      All’s well that ends well. But it was a bit worrying to suddenly lose visual acuity after MH surgery, despite having already had cataract surgery. I had no idea that posterior ocular capsule opacity existed. It is worth knowing that MH surgery brings a relatively high risk of this type of ‘secondary cataract’. Apparently it is also possible, but much rarer, for certain types of artificial lens to cloud over like a cataract, although I doubt that the victretomy gas increases this risk.

  107. Detachment Surgery Delayed

    Hi Longrow, hope everyone is well. I am well. Did not get surgery for retinal detachment back in Sept, as he felt some of the sight in this eye could be compromised. [Thought] going back in too quickly as surgery was only in June, and he felt I may not need surgery. He decided to photograph retina over next few months and check [for] changes. Consultant advised it is stable and the longer that it stays stable the happier he is. Unfortunately it is a risk of mac hole surgery and I have just been unlucky! Sometimes feel the sight in my right eye can be a little blurry and some distortion due to traction, but mainly when I am tired. Back driving but not so keen to drive in the dark. Thankfully back reading books and newspapers [in] normal sized font. So all is good. Consultant keeping an ‘eye’on the situation,excuse the pun. Not to see him until beginning of Jan. My only slight anxiety is I am flying next week from Scotland to Germany. Consultant said it was ok to do so, so fingers crossed.

  108. The procedure in Germany

    Hi. My name is Todd, a 48 year old American living in Germany. I had a severe cold with coughing and sneezing. I was sitting on my sofa [when] I noticed I was having visual problems. I first thought it was congestion from the cold. I rinsed my nose out 3 times a day. It was still the same.

    I decided to go to the doctor. The optometrist gave me a few tests. The vision in my left eye was a lot worse than I thought. He then advised me to have OCT (Optical Coherence Tomography. I was diagnosed with Macular Hole. It is roughly 365 microns going through the retina completely.

    [My wife] is a nurse. She asked around and found a university clinic, the best in the area. I went to the hospital on the 8 November and was examined, and made the earliest appointment possible. At the hospital I was told that I had a two week waiting period. During the two weeks I became very nervous. I had a vitrectomy with gas, combined with monofocal IOL lens. This is pretty much standard in Germany. Now, after reading this blog, I am glad I decided to have the lens done parallel [simultaneously?] because of the cataracts issue.

    I was operated on 22 November. The view on face down is a bit different than I have been reading. Laying on the right side with the head positioned downward, or sitting with your hands supporting your head parallel to the floor. Four days later began to see the gas level dissipated about 10-15%. One day later about 40%. This shocked me. I thought it would stay full 2-3 weeks. On 28 November I was released from the hospital and was told to hold my head parallel to the floor as much as possible. One day later I had my visual acuity checked and it was about 20% which frightened me. The gas bubble fills about 1/3 [of the eye]. Nothing I look at is very sharp. Straight object have small bends .The distortion appears to be better, I can make out faces. I hope this is a sign that the hole is closed and is healing. I am scared to death of going through this torment again. Today is the 30, and I have appointment on 15 December. No answers till then.

    • Voices patience, encouragement

      Hi Todd, reading your post takes me back to how I felt after my first mac hole surgery in April. I found it quite frightening and felt my confidence wasn’t good. Felt quite alone despite having wonderful family and friends round about me. Found long row blog really helped.

      Problem was you constantly check what you can and cannot see. Sometimes I wasn’t sure whether my eye was improving. Please give it time, Todd. You still have some of the gas bubble left, and it is early days. I initially had a wave with straight lines following surgery. This has improved over the months. It is still there but not so pronounced and my brain now seems to over-ride it.

      Life has improved since my 2 surgeries, but my eyes still remind me of the surgeries, although I have had a couple of added complications. Now moving on with life. Just back from the German Christmas markets near Hannover yesterday. Really enjoyed it and my eyes were ok after the flights which I was relieved about.

      Couldn’t have even contemplated doing that a few months ago. You will be glad to see Consultant in mid December, especially to check mac hole is closed. It lets you move on a bit. Will be thinking and hoping for a good result for you. Have patience and relax which I know isn’t easy.

      An extra little thought: My GP when I spoke to her was a bit worried that as she says going through what in effect is quite major and traumatic surgery, that maybe I needed more support, that is someone to talk to. I told her about how I joined this blog and how it helped. She was delighted and says she was very encouraged by the fact I had sought this out.

  109. I am at day 19 in the recovery process from vitrectomy surgery of my left eye. I too had cataract surgery in both eyes before the macular hole was found. I wonder if anyone has studied the relationship of the virectomy and prior cataract surgery?

  110. Someone else may know of specific studies. The general rule I was told by my eye surgeon is this: Do the cataracts first, then the macular hole. Complications can occur if surgery is done in reverse, he said.

  111. Hi folks, just thought I would say hello after nearly two years (4th November 2015) macular hole surgery and following July 2016 cataract surgery on my left eye.

    They still keep an eye on me as I had untold problems with high pressure in both eyes, found to be thick corneas. Phew!. Anyhow they managed to save some sight but as the hole was large and left too long I have very little central vision and what I do have is distorted and very glary. I rely on my right eye for reading or watching tv.

    I now have a cataract in my right eye (since 2012) but has now started to cause problems in as much as the distortion in left eye is dominating. I am waiting for an appointment for the consultant, last seen November last year. I get on with things. Not much choice really. But two years on I was hoping all the surgery would be over.

  112. Hi Longrow, my Consultant in Glasgow Scotland does the macular hole surgery and cataract surgery at the same time, it saves you having to have 2 surgeries.

  113. Following successful macular hole and cataract surgery in my right eye in January 2017, I now have an appointment with the same surgeon for the same operation in my left eye on September 18. The hole in my left eye is only Stage 1, not yet full thickness, but there was a significant deterioration in the impending macular hole in the 6 months since my last OCT scans. It is symptomatic in that I have an area of quite troublesome distortion to the right of my central vision. Six months ago the surgeon offered to operate without injecting any gas and therefore no need to recommend posturing. But I procrastinated and decided to wait a bit longer. Now he says the impending hole has progressed to the extent that there is a slight risk that the peeling of the epiretinal membrane during surgery could actually precipitate a full thickness hole. Therefore it will now be a sensible precaution to inject gas that can fix a full thickness hole, should one occur, to avoid a second surgery. It is conventional wisdom that a Stage 1 impending hole is not operated on, since there is a risk in any surgery and some holes resolve themselves. My surgeon has in no way pushed me to agree to surgery but he felt that the latest deterioration suggested that self-resolution is now unlikely and he believes he can achieve better results by operating before the hole goes full thickness. My history with the right eye, having observed and waited over two years for the hole to go full thickness and which has a slight impairment on the retina where that happened, influenced my decision to go ahead with surgery on an impending hole.

    I will have slight cataract in the left eye which would not otherwise need surgery for years but I will have it done at the same time. Since that eye is far sighted, about +250, and the right eye is normal for distance, I will hopefully have the same vision in both eyes again for the time since my 20s as a result of the second eye cataract surgery. I complained about slight light scattering in my right eye due to the cataract surgery, resulting in annoying car headlight glare at night, so the surgeon said he would use a different brand of lens implant in the hope that light scattering will not be so bad.

    Having been through the procedure once, I know it is not fun but, knowing what to expect makes me feel a lot more relaxed about things this time.

    • Hi George, wishing you well with a good outcome for your surgery on the 18th. Like you I also have had macular holes [in] both eyes. Both required surgery within a few months of each other. I agree with you I became more relaxed with the second surgery and had good faith in my surgeon. Take care.

  114. Thanks Anne. I am about to pack my bag for the op tomorrow morning. Will spend one night in the hospital just to be safe, although it is not required, and to avoid battling through the Bangkok traffic the next morning to see the surgeon again.

  115. One bad eye, delay on cataract
    I had macular hole surgery 2015 which closed the hole and cataract surgery 2016. I was left with distortion but my eye has deteriorated and I’m left with no central vision. On my consultants appointment recently I was told to ignore that eye as it was of no use and [to] concentrate on keeping the right eye safe. I have a cataract in the right eye which he won’t consider operating on at the moment as I’m so dependent on it but it is causing me some problems. I’m scared if I leave it, [it will be] too late for cataract surgery.

    • Advising a second opinion
      Very sad to hear this. It sounds as the hole re-opened or perhaps was affected by a new condition. I hope they have explained to you clearly what happened to that eye, apart from anything else in case it is something that might affect the other eye too, e.g. age related macular degeneration. I guess your surgeon wants to delay cataract surgery until there is no other choice, given your dependence on that eye for central vision. There is definitely a point at which cataracts are too advanced to operate at all. But before that, there is a point at which the surgery becomes more difficult and the chances of a successful outcome are reduced. You definitely don’t want to get to either of these points. If you are not very sure about things, please demand a second opinion. In fact, even if you are fully confident in your surgeon, because this is so important, it is advisable to get a second opinion on timing of cataract surgery. If the second surgeon agrees 100% with the first one, you will feel more confident to go along that path. Often they don’t agree 100%, since many things are a matter of opinion and depend on the experiences of each surgeon. All the best.

    • Wishing a good outcome
      Anne, I am sorry to read your post and can sense how worried you are. I too have had Mac hole surgery in both eyes in last 18 months and still have ongoing problems with my right eye as the retina detached following surgery. [I] have had further surgery and [am] now waiting to go back in end of year to have oil bubble removed and unsure of outcome. So I really feel for what you are going through, I agree with George about you seeking a second opinion about your cataract. No one could question you about this. I totally have faith in my surgeon but I would want a second opinion and I think my surgeon would be happy for me to do this. Sight is so precious. Hoping you get some answers Anne and a good outcome. Take care.

  116. Not macular degeneration
    Hi George. No its not macular degeneration but a consequence of leaving the hole initially to grow large. As it happened in June and I didn’t have surgery until November. So the results were not very good. I will defiantly try and find out from the surgeons who carried out my macular hole and subsequent cataract surgery how long I should wait for cataract surgery. Thank you.

  117. Hi Anne, I hope you can get more information about why your MH operation was unsuccessful. Obviously the chance of a good result decreases with the size of the hole and there are a host of other factors, such as the patient’s degree of myopia. At any rate, you should never be told to give up on your operated eye without a detailed explanation of why the operation was unsuccessful and why nothing more can be done.

    Re timing of cataract surgery in your other eye. I am not an expert but I am aware there are cases that become inoperable due to delay. I think these days these are mainly cases where the patient has gone legally blind and the cataract has grown so much that it has damaged the sac the lens sits in so badly that there is no longer any platform for the surgeon to seat a new intraocular lens. I think such cases nowadays are sadly seen mainly in third world countries where people have little access to healthcare. Very advanced cataracts that are still operable will also be difficult to remove without damaging the sac, and the obscuration caused by cataract will make it harder for the surgeon to measure you up for a new lens which would increase the chance of needing to wear glasses for distance or having another surgery later, if the measurement is way off. You should notice significant loss of vision when a cataract is becoming advanced. So it is probably a long way from being advanced or difficult to operate on and you may be able to wait for some time before having surgery. But if the loss of vision has got to the point where it is negatively affecting your daily activities, I think that would be the time to go for the surgery.

  118. I went back to the eye hospital on Tuesday for my appointment one month after my second MH and cataract surgery (in the other eye). Fortunately the hole, which was not full thickness but 80 -90% of the way through, is still closed but I didn’t have OCT scans this time. A week after the surgery the scans showed the hole closed and the gap behind the retina had filled in 90%.

    Despite the success of the operation I still have the classic pincushion distortion caused by MH in the form of 4 distorted boxes. That is one box away from the centre dot to the right on the Amsler grid [test for MH or other vision problems]. This is worse than the distortion I had in my other eye even after the hole went full thickness. In that case the full thickness hole caused more of a blurry spot in addition to a lesser level of pincushion distortion. The surgeon told me [it] is optimistic this will improve in time and said it was a good sign I was able to read the 20/20 uncorrected with that eye, which surprised me, as I didn’t think I had done well in the visual acuity test. I could only read the charts by looking to the right of the letter I was trying to read. We have discussed earlier in the blog how the standard visual acuity tests don’t tell the whole story since you can “cheat” in them.

    Following the cataract surgery the operated eye that was far sighted +300 (vs the other eye being zero for distance) has improved but is still far sighted +75. The surgeon also [said] this might improve in the coming weeks. Nevertheless the imbalance of eyesight between the two eyes is now greatly reduced, and I have been able to drive without glasses for the first time in 30 years.

    I still hope for improvements in my vision but will be pleased with the outcome, if it remains stable as it is now.

  119. Hi, I’m Chris. What a brill [brilliant?] journal on the macular hole. Very interesting [and] well written.

    I had macular hole surgery on the March 10, 2018, plus had cataract done at the same time as this causes one to save going back in 12 months time. I had to do only 2 days posturing which I found quite comfortable to do I pulled a bed settee out, took the glass top off my coffee table, put it under the edge of the bed at the bottom to stop it from slipping. [I also put 2 v-shaped pillows on the table,a put my head through and put my iPad on the floor and watched TV.

    I am now on day 19 and the bubble has shrunk to about a quarter. When I lift my head it’s like half moon with black trim. If I put my head down, I can see the whole bubble. Looking through the bubble close up is like it’s magnified. The bubble moves when I move.

    I have now got black dots in front of my vision through my bad eye when looking forward. It’s like having a veil over my face with little black dots. I’ve got to go the hospital on Tuesday Oct. 23 for my check up to see how things are. If you’re going for this surgery don’t be afraid. I never felt a thing and took just over an hour. I later had a cup of tea and went home to start posturing for my 2 days. Expected to have headache or some pain but I had nothing at all. Just have to wear a patch at night and make sure to put the eye drops in four times a day.

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