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Medical Forum / General / Vision / February 2005Macular hole surgery - will it stop the problem from getting worse?
I am still in a dilemma as to whether to have surgery for my macular hole. I understand that there is a good chance that it will improve my vision by a reasonable amount, though it will not completely solve the problem. If I was unlucky, and did not gain any significant improvement from the surgery, could I at least be sure that the surgery will stop the macular hole from increasing in size. And if I was luckier, and had some significant improvement, is it likely (disregarding the cataracts) that this will be just a temporary improvement. I would appreciate hearing from any readers of their experiences after surgery. Jan >I am still in a dilemma as to whether to have surgery for my macular hole. > >I understand that there is a good chance that it will improve my vision by a >reasonable amount, though it will not completely solve the problem. I didn't have the surgery, but my mother did, in 1998. Just to be sure we're talking about the same thing, she had a gas bubble injected into her eyeball and had to stay face-down for six weeks. It nearly drove her (and me) crazy, but she did it. The result: her eyes are pretty darn good. She drove for a short while afterward, against everyone's advice, but she did okay. She has since stopped driving, thankfully. She's had three Visudyne (I think) procedures since, and her vision and macular hole appear to have stabilized. She still has glaucoma in both eyes, cataract in one. Personally, I consider the surgery almost a miracle. It had been ten years since her last exam before the hole was caught, and I have little doubt she'd be blind by now without the surgery. I don't know if it will improve your vision, but I think it will stop, or at least slow, the onset of blindness. > If I >was unlucky, and did not gain any significant improvement from the surgery, >could I at least be sure that the surgery will stop the macular hole from >increasing in size. I don't know. > And if I was luckier, and had some significant >improvement, is it likely (disregarding the cataracts) that this will be >just a temporary improvement. Again, I don't know. My mother's experiences would seem to indicate a permanent improvement with a LOT of maintenance. She sees her doctors about every three months but has not had a change in her eyeglass prescription for at least five years. It took her a while post-op to adjust to her new vision (she complained of straight lines looking "crooked", for example, a square looking like a parellelogram) but she seems to have made it through. Bottom line--I'd have it done if I thought I could stand to keep my head down for a month and a half. Only you can make the call, but if my mother's experience counts for anything, it's worth it. She's seen a lot of things she'd otherwise have missed because she had it done.  Signaturecl > >I am still in a dilemma as to whether to have surgery for my macular hole. > > [quoted text clipped - 5 lines] > into her eyeball and had to stay face-down for six weeks. It nearly > drove her (and me) crazy, but she did it. My mom (also with a macular hole) has to have it done, but due to her claustrophobia she was going to have the oil-filled option, which is only slightly less good than the gas-filled option and doesn't require the face-down thing but does involve a second surgery to remove the oil. Last time we went to see her doc, he said he'd been talking to a doc in San Diego who's been doing vitrectomies for 3 years involving hundreds of patients BUT using air AND not requiring the face-down positioning -- with results the same as if they had spent time face down. This seems to square with the discussions of vitrectomy I've seen on the web, which prescribe positioning for anywhere from a few days to a few months -- if you don't need it it doesn't matter how long you do it! If it doesn't work as well as expected, she can still have the oil treatment, which involves two more surgeries. She's going to make her decision (probably in favor of air/no positioning) on March 1 and the surgery will probably take place the following Friday. > Bottom line--I'd have it done if I thought I could stand to keep my > head down for a month and a half. Only you can make the call, but if > my mother's experience counts for anything, it's worth it. She's seen > a lot of things she'd otherwise have missed because she had it done. The doc says that without the surgery hers will probably get worse. With the surgery it will probably get better. There seems to be no real downside to having it done, assuming money isn't part of the equation. SignatureCheers, Bev /\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\ When cryptography is outlawed, only outlaws will qwertzuio asdfghjk pyxcvbnml -- M. O'Dorney Macular holes are cured by sungazing and palming. That is, by rest methods. Discarding of any type of glasses is particularly mandatory. Treatment should be done properly many hours a day. <Snip> >My mom (also with a macular hole) has to have it done, but due to her >claustrophobia she was going to have the oil-filled option, which is >only slightly less good than the gas-filled option and doesn't require >the face-down thing but does involve a second surgery to remove the >oil. I wish that option had existed for Mom; it would probably have been better for her to get the second surgery than to suffer with the face-down positioning. She was pretty unhappy, and the stooped posture didn't do much for her arthritis, either. > Last time we went to see her doc, he said he'd been talking to a >doc in San Diego who's been doing vitrectomies for 3 years involving >hundreds of patients BUT using air AND not requiring the face-down >positioning -- with results the same as if they had spent time face >down. Why doesn't this surprise me? Pressure, after all, is exerted equally in all directions. >If it doesn't work as well as expected, she can still have the oil >treatment, which involves two more surgeries. She's going to make her >decision (probably in favor of air/no positioning) on March 1 and the >surgery will probably take place the following Friday. I wish you both well, and I'm glad to hear of the advances made in the last few years. > <Snip> > [quoted text clipped - 8 lines] > face-down positioning. She was pretty unhappy, and the stooped > posture didn't do much for her arthritis, either. I looked at the vitrectomy furniture and happened to see that one of the massage chairs out at the LA County Fair looked a lot like one. I tried it out. I can't imagine having to spend 2 months like that. > > Last time we went to see her doc, he said he'd been talking to a > >doc in San Diego who's been doing vitrectomies for 3 years involving [quoted text clipped - 4 lines] > Why doesn't this surprise me? Pressure, after all, is exerted equally > in all directions. The gas is slowly replaced by water, so I would guess that there is a certain amount of upward pressure, making it desirable for 'upward' to be the area of the eye that needs the pressure. The doc said that getting the pressure right is part of the operation -- if it's too low the result won't be as good; he didn't say what would happen if the pressure were too high, but I envision something like that cheesy sci-fi movie where the aliens had huge protruding eyeballs. > >If it doesn't work as well as expected, she can still have the oil > >treatment, which involves two more surgeries. She's going to make her [quoted text clipped - 3 lines] > I wish you both well, and I'm glad to hear of the advances made in the > last few years. It's probably always better to delay irrevocable treatment as long as possible on the theory that what happens today is obsolete next week. Like computer stuff... SignatureCheers, Bev --------------------------------------------------- I have no idea what you're talking about, so here's a bunny with a pancake on his head: http://www.ebaumsworld.com/forumfun/misc15.jpg >I looked at the vitrectomy furniture and happened to see that one of the >massage chairs out at the LA County Fair looked a lot like one. I tried >it out. I can't imagine having to spend 2 months like that. I did a similar thing just after my mother's surgery, but in my case I really did get a massage. I had the same thought--spending much more than ten minutes like that would really be awful. >The gas is slowly replaced by water, so I would guess that there is a >certain amount of upward pressure, making it desirable for 'upward' to [quoted text clipped - 3 lines] >pressure were too high, but I envision something like that cheesy sci-fi >movie where the aliens had huge protruding eyeballs. I'm sure it would be better to have a greater amount of pressure exerted in that direction, but have never been convinced the face-down bit was absolutely necessary in order to accomplish it. Still, it's better to be safe than sorry, especially considering the investment and the risk. > >The gas is slowly replaced by water, so I would guess that there is a The gas is absorbed by the body. Different gases are absorbed at different rates. I had plain old sterile air in mine (retinal detachment), which is absorbed in about five days. It was weird watching it slosh around in there. Of course, everything is upside down, so it looked like oil drops floating on water. The guy down the hall had a gas which took a long time to absorb, but he needed the pressure (also a retinal detachment) where it naturally occured anyway, so he didn't have to assume any particular position. Mine was on the side of my eye, so I spent five days lying on my right side. My brother had a recliner that reclined horizontally, so I could watch tv and read. I was only supposed to get up to eat and use the bathroom, but I did go on a few short walks each day. > I'm sure it would be better to have a greater amount of pressure > exerted in that direction, but have never been convinced the face-down > bit was absolutely necessary in order to accomplish it. Still, it's > better to be safe than sorry, especially considering the investment > and the risk. Yeah. I'm convinced the position is necessary, since the whole point is that the pressure is exerted where the bubble is. No point in having the bubble if it isn't putting pressure where it's needed. The eye regulates its own internal pressure, so the bubble doesn't increase the overall pressure, just the pressure where it touches the eye. SignatureDan Abel Sonoma State University AIS dabel@sonic.net A macular hole does not make one blind. It stops when it involves the central macula, leaving a blind SPOT in the center of the vision. The rest of the retina normally stays intact - you can see around it, as 99% of the retina is uninvolved. Can't read with that eye, though, or recognize faces. But one is not totally disabled either. On 2/21/05 8:31 PM, in article tecl11ldq3r0a6obdfsncoridgu8ork1qa@4ax.com, >> I am still in a dilemma as to whether to have surgery for my macular hole. >> [quoted text clipped - 41 lines] > my mother's experience counts for anything, it's worth it. She's seen > a lot of things she'd otherwise have missed because she had it done. > A macular hole does not make one blind. It stops when it involves the > central macula, leaving a blind SPOT in the center of the vision. The rest > of the retina normally stays intact - you can see around it, as 99% of the > retina is uninvolved. Can't read with that eye, though, or recognize faces. > But one is not totally disabled either. The fact that the center of vision becomes destroyed while the rest of the retina is unaffected is clear evidence of the great truth discovered by Dr. Bates: the problems of the eye and vision are largely MENTAL and not related to physical causes. When your profession will wake up from your own nightmares, we do not know. It will be too later, either. http://TheCentralFixation.com > A macular hole does not make one blind. It stops when it involves the > central macula, leaving a blind SPOT in the center of the vision. The rest > of the retina normally stays intact - you can see around it, as 99% of the > retina is uninvolved. Can't read with that eye, though, or recognize faces. > But one is not totally disabled either. If you live alone, have emphysema and can't move around much and can't drive any more, reading (including the internet) is about all you can do and yes, it IS pretty damn close to total disability. > On 2/21/05 8:31 PM, in article tecl11ldq3r0a6obdfsncoridgu8ork1qa@4ax.com, > [quoted text clipped - 43 lines] > > my mother's experience counts for anything, it's worth it. She's seen > > a lot of things she'd otherwise have missed because she had it done. SignatureCheers, Bev ================================================================ "Is there any way I can help without actually getting involved?" -- Jennifer, WKRP Note: A macular hole (ONE macular hole) is not macular holes both eyes. It will affect 1 eye only. Assuming the other eye is OK, there should not be much limitation on reading, etc. Lot of monocular folks our there who function just fine. On 2/23/05 4:44 PM, in article 421D2376.722CFBE7@myrealbox.com, "The Real Bev" <bashley@myrealbox.com> wrote: >> A macular hole does not make one blind. It stops when it involves the >> central macula, leaving a blind SPOT in the center of the vision. The rest [quoted text clipped - 54 lines] >>> my mother's experience counts for anything, it's worth it. She's seen >>> a lot of things she'd otherwise have missed because she had it done. > Note: A macular hole (ONE macular hole) is not macular holes both eyes. It > will affect 1 eye only. Assuming the other eye is OK, there should not be > much limitation on reading, etc. Lot of monocular folks our there who > function just fine. Indeed, but my mom has a macular hole in one eye and a supposedly repaired macular "blister" in the other (she needs a 6x magnifier to read newsprint, and even that's a bitch -- the blister repair left her with distorted vision in the center of the macula). If you're lucky enough to have only one it's, of course, very different. How many people develop holes/blisters in only one eye? If in one, why not in the other too? > On 2/23/05 4:44 PM, in article 421D2376.722CFBE7@myrealbox.com, "The Real > Bev" <bashley@myrealbox.com> wrote: [quoted text clipped - 57 lines] > >>> my mother's experience counts for anything, it's worth it. She's seen > >>> a lot of things she'd otherwise have missed because she had it done. SignatureCheers, Bev ooooooooooooooooooooooooooooooooooooooooooooooooooooo "With sufficient thrust, pigs fly just fine. However, this is not necessarily a good idea...." > But one is not totally disabled either. > > If you live alone, have emphysema and can't move around much and can't > drive any more, reading (including the internet) is about all you can do > and yes, it IS pretty damn close to total disability. The fact that he can cure himself and slip out of that disability does not stir in you any sense of sympathy for this poor fellow? You choose to continue to condemn him to your own weakness, ad a professional, and as a human being as well. >A macular hole does not make one blind. It stops when it involves the >central macula, leaving a blind SPOT in the center of the vision. The rest >of the retina normally stays intact - you can see around it, as 99% of the >retina is uninvolved. Can't read with that eye, though, or recognize faces. >But one is not totally disabled either. I probably knew that, come to think of it. I guess my confusion arose from the emotional intensity my mom displayed after her diagnosis. Sorry if I alarmed anyone unnecessarily.
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