Macular hole surgery - will it stop the problem from getting worse?

I am still in a dilemma as to whether to have surgery for my macular hole.

I understand that there is a good chance that it will improve my vision by a
reasonable amount, though it will not completely solve the problem. If I
was unlucky, and did not gain any significant improvement from the surgery,
could I at least be sure that the surgery will stop the macular hole from
increasing in size. And if I was luckier, and had some significant
improvement, is it likely (disregarding the cataracts) that this will be
just a temporary improvement.

I would appreciate hearing from any readers of their experiences after
surgery.

Jan

On Tue, 22 Feb 2005 10:16:21 +1100, "Doug McKenzie"
<(E-Mail Removed)> wrote:

>I am still in a dilemma as to whether to have surgery for my macular hole.
>
>I understand that there is a good chance that it will improve my vision by a
>reasonable amount, though it will not completely solve the problem.

I didn't have the surgery, but my mother did, in 1998. Just to be
sure we're talking about the same thing, she had a gas bubble injected
into her eyeball and had to stay face-down for six weeks. It nearly
drove her (and me) crazy, but she did it.

The result: her eyes are pretty darn good. She drove for a short
while afterward, against everyone's advice, but she did okay. She has
since stopped driving, thankfully. She's had three Visudyne (I think)
procedures since, and her vision and macular hole appear to have
stabilized. She still has glaucoma in both eyes, cataract in one.

Personally, I consider the surgery almost a miracle. It had been ten
years since her last exam before the hole was caught, and I have
little doubt she'd be blind by now without the surgery. I don't know
if it will improve your vision, but I think it will stop, or at least
slow, the onset of blindness.

> If I
>was unlucky, and did not gain any significant improvement from the surgery,
>could I at least be sure that the surgery will stop the macular hole from
>increasing in size.

I don't know.

> And if I was luckier, and had some significant
>improvement, is it likely (disregarding the cataracts) that this will be
>just a temporary improvement.

Again, I don't know. My mother's experiences would seem to indicate a
permanent improvement with a LOT of maintenance. She sees her doctors
about every three months but has not had a change in her eyeglass
prescription for at least five years. It took her a while post-op to
adjust to her new vision (she complained of straight lines looking
"crooked", for example, a square looking like a parellelogram) but she
seems to have made it through.

Bottom line--I'd have it done if I thought I could stand to keep my
head down for a month and a half. Only you can make the call, but if
my mother's experience counts for anything, it's worth it. She's seen
a lot of things she'd otherwise have missed because she had it done.

--
cl

cl wrote:
>
> On Tue, 22 Feb 2005 10:16:21 +1100, "Doug McKenzie"
> <(E-Mail Removed)> wrote:
>
> >I am still in a dilemma as to whether to have surgery for my macular hole.
> >
> >I understand that there is a good chance that it will improve my vision by a
> >reasonable amount, though it will not completely solve the problem.
>
> I didn't have the surgery, but my mother did, in 1998. Just to be
> sure we're talking about the same thing, she had a gas bubble injected
> into her eyeball and had to stay face-down for six weeks. It nearly
> drove her (and me) crazy, but she did it.

My mom (also with a macular hole) has to have it done, but due to her
claustrophobia she was going to have the oil-filled option, which is
only slightly less good than the gas-filled option and doesn't require
the face-down thing but does involve a second surgery to remove the
oil. Last time we went to see her doc, he said he'd been talking to a
doc in San Diego who's been doing vitrectomies for 3 years involving
hundreds of patients BUT using air AND not requiring the face-down
positioning -- with results the same as if they had spent time face
down. This seems to square with the discussions of vitrectomy I've seen
on the web, which prescribe positioning for anywhere from a few days to
a few months -- if you don't need it it doesn't matter how long you do
it!

If it doesn't work as well as expected, she can still have the oil
treatment, which involves two more surgeries. She's going to make her
decision (probably in favor of air/no positioning) on March 1 and the
surgery will probably take place the following Friday.

> Bottom line--I'd have it done if I thought I could stand to keep my
> head down for a month and a half. Only you can make the call, but if
> my mother's experience counts for anything, it's worth it. She's seen
> a lot of things she'd otherwise have missed because she had it done.

The doc says that without the surgery hers will probably get worse.
With the surgery it will probably get better. There seems to be no real
downside to having it done, assuming money isn't part of the equation.

--
Cheers,
Bev
/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\/\
When cryptography is outlawed, only outlaws will
qwertzuio asdfghjk pyxcvbnml -- M. O'Dorney

Macular holes are cured by sungazing and palming.

That is, by rest methods.

Discarding of any type of glasses is particularly mandatory.

Treatment should be done properly many hours a day.

On Mon, 21 Feb 2005 22:11:20 -0800, The Real Bev
<(E-Mail Removed)> wrote:

<Snip>

>My mom (also with a macular hole) has to have it done, but due to her
>claustrophobia she was going to have the oil-filled option, which is
>only slightly less good than the gas-filled option and doesn't require
>the face-down thing but does involve a second surgery to remove the
>oil.

I wish that option had existed for Mom; it would probably have been
better for her to get the second surgery than to suffer with the
face-down positioning. She was pretty unhappy, and the stooped
posture didn't do much for her arthritis, either.

> Last time we went to see her doc, he said he'd been talking to a
>doc in San Diego who's been doing vitrectomies for 3 years involving
>hundreds of patients BUT using air AND not requiring the face-down
>positioning -- with results the same as if they had spent time face
>down.

Why doesn't this surprise me? Pressure, after all, is exerted equally
in all directions.

>If it doesn't work as well as expected, she can still have the oil
>treatment, which involves two more surgeries. She's going to make her
>decision (probably in favor of air/no positioning) on March 1 and the
>surgery will probably take place the following Friday.

I wish you both well, and I'm glad to hear of the advances made in the
last few years.

cl wrote:
>
> On Mon, 21 Feb 2005 22:11:20 -0800, The Real Bev
> <(E-Mail Removed)> wrote:
>
> <Snip>
>
> >My mom (also with a macular hole) has to have it done, but due to her
> >claustrophobia she was going to have the oil-filled option, which is
> >only slightly less good than the gas-filled option and doesn't require
> >the face-down thing but does involve a second surgery to remove the
> >oil.
>
> I wish that option had existed for Mom; it would probably have been
> better for her to get the second surgery than to suffer with the
> face-down positioning. She was pretty unhappy, and the stooped
> posture didn't do much for her arthritis, either.

I looked at the vitrectomy furniture and happened to see that one of the
massage chairs out at the LA County Fair looked a lot like one. I tried
it out. I can't imagine having to spend 2 months like that.

> > Last time we went to see her doc, he said he'd been talking to a
> >doc in San Diego who's been doing vitrectomies for 3 years involving
> >hundreds of patients BUT using air AND not requiring the face-down
> >positioning -- with results the same as if they had spent time face
> >down.
>
> Why doesn't this surprise me? Pressure, after all, is exerted equally
> in all directions.

The gas is slowly replaced by water, so I would guess that there is a
certain amount of upward pressure, making it desirable for 'upward' to
be the area of the eye that needs the pressure. The doc said that
getting the pressure right is part of the operation -- if it's too low
the result won't be as good; he didn't say what would happen if the
pressure were too high, but I envision something like that cheesy sci-fi
movie where the aliens had huge protruding eyeballs.

> >If it doesn't work as well as expected, she can still have the oil
> >treatment, which involves two more surgeries. She's going to make her
> >decision (probably in favor of air/no positioning) on March 1 and the
> >surgery will probably take place the following Friday.
>
> I wish you both well, and I'm glad to hear of the advances made in the
> last few years.

It's probably always better to delay irrevocable treatment as long as
possible on the theory that what happens today is obsolete next week.
Like computer stuff...

--
Cheers, Bev
---------------------------------------------------
I have no idea what you're talking about, so here's
a bunny with a pancake on his head:
http://www.ebaumsworld.com/forumfun/misc15.jpg

A macular hole does not make one blind. It stops when it involves the
central macula, leaving a blind SPOT in the center of the vision. The rest
of the retina normally stays intact - you can see around it, as 99% of the
retina is uninvolved. Can't read with that eye, though, or recognize faces.
But one is not totally disabled either.





On 2/21/05 8:31 PM, in article (E-Mail Removed),
"cl" <(E-Mail Removed)> wrote:

> On Tue, 22 Feb 2005 10:16:21 +1100, "Doug McKenzie"
> <(E-Mail Removed)> wrote:
>
>> I am still in a dilemma as to whether to have surgery for my macular hole.
>>
>> I understand that there is a good chance that it will improve my vision by a
>> reasonable amount, though it will not completely solve the problem.
>
> I didn't have the surgery, but my mother did, in 1998. Just to be
> sure we're talking about the same thing, she had a gas bubble injected
> into her eyeball and had to stay face-down for six weeks. It nearly
> drove her (and me) crazy, but she did it.
>
> The result: her eyes are pretty darn good. She drove for a short
> while afterward, against everyone's advice, but she did okay. She has
> since stopped driving, thankfully. She's had three Visudyne (I think)
> procedures since, and her vision and macular hole appear to have
> stabilized. She still has glaucoma in both eyes, cataract in one.
>
> Personally, I consider the surgery almost a miracle. It had been ten
> years since her last exam before the hole was caught, and I have
> little doubt she'd be blind by now without the surgery. I don't know
> if it will improve your vision, but I think it will stop, or at least
> slow, the onset of blindness.
>
>> If I
>> was unlucky, and did not gain any significant improvement from the surgery,
>> could I at least be sure that the surgery will stop the macular hole from
>> increasing in size.
>
> I don't know.
>
>> And if I was luckier, and had some significant
>> improvement, is it likely (disregarding the cataracts) that this will be
>> just a temporary improvement.
>
> Again, I don't know. My mother's experiences would seem to indicate a
> permanent improvement with a LOT of maintenance. She sees her doctors
> about every three months but has not had a change in her eyeglass
> prescription for at least five years. It took her a while post-op to
> adjust to her new vision (she complained of straight lines looking
> "crooked", for example, a square looking like a parellelogram) but she
> seems to have made it through.
>
> Bottom line--I'd have it done if I thought I could stand to keep my
> head down for a month and a half. Only you can make the call, but if
> my mother's experience counts for anything, it's worth it. She's seen
> a lot of things she'd otherwise have missed because she had it done.

David Robins, MD wrote:
> A macular hole does not make one blind. It stops when it involves the
> central macula, leaving a blind SPOT in the center of the vision. The
rest
> of the retina normally stays intact - you can see around it, as 99%
of the
> retina is uninvolved. Can't read with that eye, though, or recognize
faces.
> But one is not totally disabled either.


The fact that the center of vision becomes destroyed while the rest of
the retina is unaffected is clear evidence of the great truth
discovered by Dr. Bates: the problems of the eye and vision are largely
MENTAL and not related to physical causes.

When your profession will wake up from your own nightmares, we do not
know.

It will be too later, either.

http://TheCentralFixation.com

"David Robins, MD" wrote:
>
> A macular hole does not make one blind. It stops when it involves the
> central macula, leaving a blind SPOT in the center of the vision. The rest
> of the retina normally stays intact - you can see around it, as 99% of the
> retina is uninvolved. Can't read with that eye, though, or recognize faces.
> But one is not totally disabled either.

If you live alone, have emphysema and can't move around much and can't
drive any more, reading (including the internet) is about all you can do
and yes, it IS pretty damn close to total disability.

> On 2/21/05 8:31 PM, in article (E-Mail Removed),
> "cl" <(E-Mail Removed)> wrote:
>
> > On Tue, 22 Feb 2005 10:16:21 +1100, "Doug McKenzie"
> > <(E-Mail Removed)> wrote:
> >
> >> I am still in a dilemma as to whether to have surgery for my macular hole.
> >>
> >> I understand that there is a good chance that it will improve my vision by a
> >> reasonable amount, though it will not completely solve the problem.
> >
> > I didn't have the surgery, but my mother did, in 1998. Just to be
> > sure we're talking about the same thing, she had a gas bubble injected
> > into her eyeball and had to stay face-down for six weeks. It nearly
> > drove her (and me) crazy, but she did it.
> >
> > The result: her eyes are pretty darn good. She drove for a short
> > while afterward, against everyone's advice, but she did okay. She has
> > since stopped driving, thankfully. She's had three Visudyne (I think)
> > procedures since, and her vision and macular hole appear to have
> > stabilized. She still has glaucoma in both eyes, cataract in one.
> >
> > Personally, I consider the surgery almost a miracle. It had been ten
> > years since her last exam before the hole was caught, and I have
> > little doubt she'd be blind by now without the surgery. I don't know
> > if it will improve your vision, but I think it will stop, or at least
> > slow, the onset of blindness.
> >
> >> If I
> >> was unlucky, and did not gain any significant improvement from the surgery,
> >> could I at least be sure that the surgery will stop the macular hole from
> >> increasing in size.
> >
> > I don't know.
> >
> >> And if I was luckier, and had some significant
> >> improvement, is it likely (disregarding the cataracts) that this will be
> >> just a temporary improvement.
> >
> > Again, I don't know. My mother's experiences would seem to indicate a
> > permanent improvement with a LOT of maintenance. She sees her doctors
> > about every three months but has not had a change in her eyeglass
> > prescription for at least five years. It took her a while post-op to
> > adjust to her new vision (she complained of straight lines looking
> > "crooked", for example, a square looking like a parellelogram) but she
> > seems to have made it through.
> >
> > Bottom line--I'd have it done if I thought I could stand to keep my
> > head down for a month and a half. Only you can make the call, but if
> > my mother's experience counts for anything, it's worth it. She's seen
> > a lot of things she'd otherwise have missed because she had it done.

--
Cheers, Bev
================================================== ==============
"Is there any way I can help without actually getting involved?"
-- Jennifer, WKRP

Note: A macular hole (ONE macular hole) is not macular holes both eyes. It
will affect 1 eye only. Assuming the other eye is OK, there should not be
much limitation on reading, etc. Lot of monocular folks our there who
function just fine.





On 2/23/05 4:44 PM, in article (E-Mail Removed), "The Real
Bev" <(E-Mail Removed)> wrote:

> "David Robins, MD" wrote:
>>
>> A macular hole does not make one blind. It stops when it involves the
>> central macula, leaving a blind SPOT in the center of the vision. The rest
>> of the retina normally stays intact - you can see around it, as 99% of the
>> retina is uninvolved. Can't read with that eye, though, or recognize faces.
>> But one is not totally disabled either.
>
> If you live alone, have emphysema and can't move around much and can't
> drive any more, reading (including the internet) is about all you can do
> and yes, it IS pretty damn close to total disability.
>
>> On 2/21/05 8:31 PM, in article (E-Mail Removed),
>> "cl" <(E-Mail Removed)> wrote:
>>
>>> On Tue, 22 Feb 2005 10:16:21 +1100, "Doug McKenzie"
>>> <(E-Mail Removed)> wrote:
>>>
>>>> I am still in a dilemma as to whether to have surgery for my macular hole.
>>>>
>>>> I understand that there is a good chance that it will improve my vision by
>>>> a
>>>> reasonable amount, though it will not completely solve the problem.
>>>
>>> I didn't have the surgery, but my mother did, in 1998. Just to be
>>> sure we're talking about the same thing, she had a gas bubble injected
>>> into her eyeball and had to stay face-down for six weeks. It nearly
>>> drove her (and me) crazy, but she did it.
>>>
>>> The result: her eyes are pretty darn good. She drove for a short
>>> while afterward, against everyone's advice, but she did okay. She has
>>> since stopped driving, thankfully. She's had three Visudyne (I think)
>>> procedures since, and her vision and macular hole appear to have
>>> stabilized. She still has glaucoma in both eyes, cataract in one.
>>>
>>> Personally, I consider the surgery almost a miracle. It had been ten
>>> years since her last exam before the hole was caught, and I have
>>> little doubt she'd be blind by now without the surgery. I don't know
>>> if it will improve your vision, but I think it will stop, or at least
>>> slow, the onset of blindness.
>>>
>>>> If I
>>>> was unlucky, and did not gain any significant improvement from the surgery,
>>>> could I at least be sure that the surgery will stop the macular hole from
>>>> increasing in size.
>>>
>>> I don't know.
>>>
>>>> And if I was luckier, and had some significant
>>>> improvement, is it likely (disregarding the cataracts) that this will be
>>>> just a temporary improvement.
>>>
>>> Again, I don't know. My mother's experiences would seem to indicate a
>>> permanent improvement with a LOT of maintenance. She sees her doctors
>>> about every three months but has not had a change in her eyeglass
>>> prescription for at least five years. It took her a while post-op to
>>> adjust to her new vision (she complained of straight lines looking
>>> "crooked", for example, a square looking like a parellelogram) but she
>>> seems to have made it through.
>>>
>>> Bottom line--I'd have it done if I thought I could stand to keep my
>>> head down for a month and a half. Only you can make the call, but if
>>> my mother's experience counts for anything, it's worth it. She's seen
>>> a lot of things she'd otherwise have missed because she had it done.