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Macular hole

A macular hole is a small gap in the centre of the retina, the light-sensitive lining of the eye. This is what we use for seeing fine details such as when reading, watching television or threading needles.

What are the
symptoms?

Patients with macular holes notice distorted vision, with ‘jumbling up’ of letters when reading or even a blind spot in the centre of the vision from the affected eye.

Who needs macular
hole surgery?

Surgery is indicated when the hole is diagnosed and involves removing the vitreous humour, the clear substance which fills the back cavity of the eye. The taut lining of the retina is then removed to allow enough give for the hole to close. Finally, the eye is filled with a special gas which allows the hole to heal. Macular holes very rarely close on their own.

What are the
benefits?

The main benefit is the preservation of central vision in your eye. Without treatment, almost all macular holes become chronic, with significant loss of central detailed vision. Surgery is the most successful approach to treat a macular hole. Timely treatment within weeks to a few months is essential in order to achieve the best possible results.

After surgery you will have a bubble of gas in your eye. You must not travel by air or climb high altitudes until the gas is absorbed which could take between two to four weeks. Your consultant will talk you through everything you need to know about this.

Vitreoretinal
surgery explained

Your pre-operative appointment Before going ahead with your procedure, your consultant fully assesses your eye health. If you are having combined cataract and retinal surgery, we will carry out a biometry test to ensure your replacement lens is the correct one for you. Your consultant will explain the procedure in detail and will be happy to answer any questions you may have.

What happens
during surgery?

Vitreoretinal surgery is a relatively straightforward procedure that normally takes between 30-40 minutes. Most vitreoretinal operations are performed under a local anaesthetic. This means you will be awake, but you will not be able to feel any pain. You may see a bright light and some movement, but you will not feel any discomfort. Your surgeon will talk you through everything they are doing.

This procedure is usually carried out on a day patient basis, so you’ll be home the same day. You will not be able to drive home and we recommend having someone available to look after you for about 24 hours after your procedure.

What happens
after surgery?

We will arrange all necessary follow-up appointments with your consultant to ensure your recovery is complete and your vision is the best it can be.

How do I get referred?

Your optician or GP will discuss the various treatment options available to you and where you can choose to have your treatment. You’ll be able to take the time to decide where you’d like to be treated, and your GP or optician will make the arrangements for your referral.

How to refer

Please follow your local protocol regarding referrals – we accept direct referrals by secure email, fax, OptoManager and post. Please call us on the number at the top of this page if you would like any further information about making a referral to Newmedica.

  • BMI >40, weight >160kg and unable to transfer independently
  • Uncontrolled hypertension – persistent diastolic >100mmHg
  • MI or CVA within 3 months of surgery MRSA positive
  • Active exposed skin infection Indwelling defibrillators
  • Poorly controlled diabetes – BS >20

For optometrists
Send a letter to the patient’s GP with GOS18 requesting an onward referral via ERS.

For GPs and Referral Centres
Send a referral form to Newmedica with GOS18 by post or secure fax 020 7924 6262 or email to: 
newmedica.referrals@nhs.net

Cataract and oculoplastic referrals will be assessed against local criteria.

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