Dr. Diva Kant Misra

A macular hole can often be repaired using an operation called a vitrectomy.

The operation is successful in closing the hole in around 9 out of 10 people who’ve had the hole for less than 6 months. If the hole has been present for a year or longer, the success rate will be lower.

Even if surgery does not close the hole, your vision will usually at least become stable, and you may find you have less vision distortion.

In a minority of patients, the hole does not close despite surgery, and the central vision can continue to deteriorate. However, a second operation can still be successful in closing the hole.

Ocriplasmin injection

If a macular hole is caused by vitreomacular traction, it may be possible to treat it with an injection of ocriplasmin, also called Jetrea, into the eye. The injection helps the vitreous jelly inside your eye to separate from the back of the eye and allows the macular hole to close.

The injection takes a few seconds and you’ll be given local anaesthetic, as eye drops or an injection, so you won’t feel any pain. You’ll also be given eye drops to dilate your pupil so the ophthalmologist can see the back of your eye.

An ocriplasmin injection is usually only available in the early stages – while the macular hole is less than 400 micrometres wide – but causing severe symptoms.

Ocriplasmin can cause some mild side effects, which usually go away, such as:

• temporary discomfort, redness, dryness or itching
• swelling of your eye or eyelid
• sensitivity to light
• flashing lights
• blurred, distorted vision
• decrease in vision or blind spots

A small number of people may develop more severe side effects, such as a noticeable loss of vision, enlargement of the macular hole or retinal detachment. Surgery is usually needed to correct macular hole enlargement or retinal detachment.

Seek help immediately if you have:

• severely decreased or distorted vision
• severe eye pain
• double vision, headaches, or you are feeling or being sick

Your vision may be blurry immediately after the injection. You should not drive or use any tools or machines until it’s back to normal.

If the ocriplasmin injection fails to close the macular hole, vitrectomy surgery may be suggested to close the macular hole and improve the vision.