Monday, May 4, 2009

Macular Hole


My mother called to let me know that her eye doctor had found something during her yearly checkup. I'm amazed that she hadn't noticed the problem on her own. When he covered her right eye to test her left eye, she realized that she could not see out of it! He sent to her to a specialist one town over and the diagnosis is that she has a Macular Hole:

A macular hole describes a central defect in the retina. The macula is the central region of the retina, and is responsible for critical vision including reading, driving, and watching television. A hole develops as the vitreous gel ages. This gel which fills the eye has the consistency of jello. The vitreous gel goes through changes with age which frequently results in floaters. Abnormal adherence of the vitreous to the macular region may result in traction or pulling resulting in a macular hole. There are 4 stages of a macular hole, all of which can result in some degree of symptoms. The most common symptom includes distortion and reduced vision for both near and distance. A macular hole is diagnosed by the ophthalmologist after dilated retinal examination. Optical Coherence Tomography (OCT) helps evaluate macular holes.



So she is waiting now for a surgery date, which will likely be sometime in June. The surgery sound relatively easy (not that I could ever have eye surgery done while being awake. It's making my eyes water just writing about it **shudder**) The hard part is the recovery:


Refinements in the surgical treatment of macular hole has steadily improved outcome. The procedure involves the removal of the vitreous gel (vitrectomy), placement of a temporary gas bubble in the eye and often removal of a membrane surrounding the hole. Surgery is typically performed in an ambulatory setting under local anesthesia, although general anesthesia can be utilized. The gas bubble is put in the eye so the hole can close under “dry” environment, the fluid in the eye can keep the hole open. In order to keep fluid away from the hole while it closes it is necessary for the patient to remain in a prone (facedown) position anywhere from several days to 2 weeks. It may take up to 6 weeks for the air bubble to completely resolve from the eye.

So for up to 2 weeks after the surgery she will have to be either lying one her stomach or walking around with her head bent down looking at her shoes. Luckily my dad can drive and she has lots of friends in town that can help them out if need be. Liam and I are headed there for our vacation on June 24th. I hope the dates of our visit don't overlap her recovery time, as she is really looking forward to spending the week with Liam.


It's so hard to watch your parents age, but it's even harder when you live so far away from them. As an only child who's parents are 67 and 73 and starting to have health problems (my mom was also recently diagnosed with Type 1 insulin dependent diabetes), I am suddenly realizing the responsibilities that will befall me in the coming years.
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