Introduction
At The Retina Clinic London, we provide expert care for diagnosing and treating macular holes, combining advanced imaging technology with state-of-the-art surgical techniques. A macular hole is a small tear or break in the macula, the part of the retina responsible for sharp, central vision. Without timely intervention, macular holes can lead to significant vision loss, particularly in the centre of your visual field.
Our team, led by Professor Paulo Stanga, delivers bespoke treatment plans using the latest surgical innovations to improve visual outcomes and quality of life.
What is a Macular Hole?
The macula is a small but critical area at the centre of the retina that allows you to see fine details and perform activities like reading and driving. A macular hole develops when the inner layers of the retina form a tear, often due to age-related changes in the vitreous, the gel-like substance that fills the eye. This tear disrupts central vision, making daily tasks more challenging.
What Causes a Macular Hole?
Several factors can contribute to the development of a macular hole:
- Vitreous Detachment: As the vitreous shrinks with age, it can pull away from the retina, sometimes causing a tear in the macula.
- Prior Eye Surgery: Procedures such as cataract surgery may increase the risk of developing a macular hole.
- High Myopia: Severe near-sightedness can cause retinal changes, increasing the likelihood of a macular hole.
- Underlying Eye Conditions: Diseases such as diabetic retinopathy or age-related macular degeneration (AMD) can elevate the risk.
- Eye Injury or Trauma: A blow to the eye can damage the retina and lead to a macular hole.
Symptoms of a Macular Hole
Symptoms of a macular hole can vary depending on its size and severity. Common signs include:
- Blurry or Distorted Central Vision: Difficulty seeing fine details, such as small text.
- Dark or Empty Spot: A shadowy area in the centre of your visual field.
- Visual Distortions (Metamorphopsia): Straight lines appear bent or wavy.
- Reduced Visual Acuity: Objects in the centre of your vision may seem smaller or less distinct.
If you experience any of these symptoms, early evaluation is essential to prevent further vision loss.
How is a Macular Hole Diagnosed?
At The Retina Clinic London, we use advanced imaging technologies and comprehensive eye exams to diagnose macular holes and assess their severity.
Diagnostic Tools
- High-Resolution Optical Coherence Tomography (OCT)
Provides detailed cross-sectional images of the retina, confirming the presence of a macular hole and assessing its size and impact on surrounding tissues. - Ultrawidefield Fundus Imaging
Captures the entire retina in a single image to detect co-existing conditions, such as retinal tears or diabetic retinopathy. - Ultrawidefield Navigated Peripheral OCT
Examines the structure of the peripheral retina in areas identified during other imaging, ensuring a thorough evaluation of linked abnormalities. - Visual Acuity Testing
Measures the impact of the macular hole on your vision and tracks changes over time.
How is a Macular Hole Treated?
The best treatment option depends on the severity of the macular hole and the symptoms it causes. At The Retina Clinic London, we offer:
- Monitoring
For small macular holes or mild symptoms, regular monitoring with OCT imaging may be recommended. This allows us to track any changes over time and intervene promptly if the hole progresses. - Surgery Vitrectomy
For larger or symptomatic macular holes, a vitrectomy is the gold-standard treatment. At The Retina Clinic London, vitrectomy surgery is performed in our dedicated onsite operating theatre, equipped with the latest surgical tools and operating microscopes.
Advanced Surgical Techniques
- ILM (Internal Limiting Membrane) Inverted Flap Technique:
In cases of larger or more complex macular holes, this technique is used to gently peel and reposition the internal limiting membrane (ILM) over the hole. This creates a scaffold that promotes tissue repair and closure of the hole, offering improved outcomes for more challenging cases. - Standard Vitrectomy with Gas Bubble Injection:
The vitreous gel is removed to relieve traction on the macula, and a gas bubble is injected into the eye to gently press against the hole, encouraging it to close naturally. - Peeling of Epiretinal Membranes (if present):
In some cases, additional scar tissue on the retina (epiretinal membrane) may need to be carefully removed to optimise visual outcomes.
Our surgeons will discuss the most appropriate technique for your condition and explain what to expect from surgery, including the anticipated visual recovery timeline.
What to Expect After Surgery
Recovery following macular hole surgery requires careful adherence to post-operative instructions. At The Retina Clinic London, we offer a comprehensive aftercare programme to support you throughout the process.
Healing Process: Vision typically improves gradually over several weeks to months, depending on the size and duration of the macular hole.
Face-Down Positioning: You may need to maintain a face-down position for a few days after surgery to help the gas bubble stay in place and aid healing. Our team will provide clear, personalised instructions.
Follow-Up Care: Regular post-operative appointments include OCT imaging to monitor the closure of the macular hole and ensure recovery is on track.
Supportive Care: Eye drops will be prescribed to prevent infection and inflammation, and we will guide you on activities to avoid during recovery.
Our team will be with you every step of the way, ensuring your recovery is smooth and your visual outcomes are maximised.
Why Choose The Retina Clinic London for Macular Hole Treatment?
At The Retina Clinic London, we combine expertise, state-of-the-art technology, and personalised care to provide world-class treatment for macular holes.
What Sets Us Apart
World-Class Expertise: Led by Professor Paulo Stanga, our team has decades of experience in treating macular holes using advanced surgical techniques.
Cutting-Edge Diagnostics: Our comprehensive assessments include OCT, ultrawidefield fundus imaging, and navigated peripheral OCT for precise diagnosis and treatment planning.
Onsite Operating Theatre: All surgeries are performed in our dedicated onsite theatre, equipped with the latest operating microscope and advanced surgical machines.
Advanced Surgical Techniques: We use specialised methods such as the ILM inverted flap technique to ensure optimal outcomes for complex cases.
Personalised Care Plans: Each patient receives a tailored treatment plan, from pre-operative evaluation to post-operative recovery.
Comprehensive Aftercare: Our follow-up programme ensures you are closely monitored and supported throughout your recovery.
Take the First Step Towards Restoring Your Vision
If you are experiencing symptoms of a macular hole or have been diagnosed with the condition, contact The Retina Clinic London today. Our experienced team is here to guide you through the process and provide world-class care at every stage of your treatment.
To schedule a consultation, call +44 (0)20 4548 5310 or email info@theretinacliniclondon.com.
