Macula Hole Flashcards
What is a macular hole?
A hole at the macula, often occurring after a PVD due to strong vitreous-macula attachment (VMT), or from ERMs, severe eye injury, retinal detachment (RD), or long-lasting CMO.
What are common causes of a macular hole?
PVD, ERMs, Severe eye injury, RD, Long-lasting CMO.
What are the signs of a macular hole on examination?
Hole at the macula, appearing redder, OCT shows either a full-thickness or lamellar hole, Loss of foveolar depression.
How does a macular hole appear on OCT?
Either as a full-thickness hole or a lamellar hole.
What is lost in a macular hole?
Foveolar depression.
What are the key symptoms of a macular hole?
Reduced vision, Blurry patch in the center of vision or a missing patch, Distortion of vision.
What should be done if a patient has a lamellar macular hole and is asymptomatic?
Provide an Amsler grid for self-monitoring, advise the patient to return if vision worsens, and review every 12 months.
What is the management for a full-thickness macular hole or if vision is affected?
Routine referral to HES for treatment, vitrectomy to close the hole.
What is the prognosis for a macular hole after a vitrectomy?
Visual outcomes are generally favorable, with better preoperative acuity leading to better postoperative results.
What can happen to the vision in eyes with worse preoperative acuity after macular hole surgery?
They often experience the greatest absolute postoperative improvement.
What is a potential complication after successful macular hole surgery?
A small number of macular holes can recur.
What surgery is typically performed to treat a macular hole?
Pars plana vitrectomy.
When should a patient with a full-thickness macular hole be referred for surgery?
If the hole is full-thickness or vision is affected, routine referral to HES.
How often should an asymptomatic patient with a lamellar macular hole be reviewed?
Every 12 months (12/12 review).
What tool should be given to patients with a lamellar macular hole for self-monitoring?
An Amsler grid to monitor for changes in vision.
