Patients with macular hole are presenting with a relatively abrupt loss of central vision from one eye, metamorphopsia-distortion of images of varying size and shape.
A macular hole is usually created due to an abnormally strong contact of the vitreous body (jelly of the eye) with the retina. The separation of the vitreous off the retina creates centrifugal forces in the macula and creates the hole.
Vitreo macular traction is also an abnormally strong attachment of the vitreous to the macula.
They appear from a mild alteration in the quality of vision to significant distortion of images or even loss of central vision over a period of weeks to months. They can be very mild as they occur primarily in one eye and are often not noticed unless the normal eye is covered to exclude overlapping images. Unfortunately, this is also the main cause of delayed treatment in the above diseases resulting in poor visual outcomes.
Treatment for symptomatic, full thickness macular holes is surgical. It is performed with vitrectomy surgery under local anesthesia and usually lasts about an hour.
The recovery of vision is NOT rapid, but usually biphasic, with the initial results in 3 months, while the improvement of vision can continue to improve up to a year after surgery!
In the early post operative period the patient should keep his face down for 3 days.