Macular Hole

Macular Hole

macular hole

Macular holes typically affect elderly patients and are caused by progressive vitreoretinal traction at the center of the retina or macula. Although there are various reason that macular holes form, often the exact cause is unknown. Macular holes do have several stages of development from partial thickness macular holes to full thickness defects. The symptoms of macular holes include a central blind spot, central blurriness or distorted central vision. Your doctor can perform a full ophthalmic and retinal exam in order to determine the extent of the macular hole.

The treatments for macular holes include:

  • Observation if the macular hole is early and partial thickness
  • Surgical intervention called pars plana vitrectomy with gas injection is necessary to close full thickness macular holes. This is done in order to improve visual acuity in patient.

Retinal Detachment

Retinal Detachment

vitreous fluid entering retinal tear,
causing retinal detachment

The retina is a photosensitive tissue within the eye that allows us to see. The retina lines the back of the eye similarly to how camera film lines the back of a camera.

Rhegmatogenous Retinal Detachment – This is the most common type of retinal detachment, which occurs when retinal tears are formed and vitreous fluid leaks under the retina causing a separation of the retina from the back wall of the eye. Without treatment this will lead to blindness.

Risk factors for retinal detachment:

  • Retinal tear
  • Posterior vitreous detachment
  • Myopia (near sightedness)
  • Injuries to the eye

Symptoms of Retinal Detachment

retinal detachement with retinal tears

retinal detachment with retinal tears

Retinal detachment is an ocular emergency that requires immediate treatment. Symptoms would include:

  • Sudden onset of floaters
  • Flashing lights
  • A shadow or curtain coming from the side of the visual field toward the center
  • Loss of peripheral vision

Diagnostic Testing

Once again, the doctor performs a full dilated ophthalmic and retinal examination to determine the type and extent of retinal detachment.


  • Laser photocoagulation – Small and early retinal detachments can often be treated with in-office laser photocoagulation alone.
  • More extensive retinal detachments can be treated with various methods such as:
  • In office pneumatic retinopexy
  • Pars plana vitrectomy with gas injection
  • Pars plana vitrectomy with scleral buckle
  • Scleral buckle alone

Retinal Vein Occlusion

This is a disease of the retina that occurs due to blockage of blood flow within the retinal veins. It results in retinal bleeding, retinal swelling and loss of vision. There are two types of retinal vein occlusions and these include:

branch retinal vein occlusion

branch retinal vein occlusion

central retinal vein occlusion

central retinal vein occlusion

Causes of retinal vein occlusions include arteriosclerosis or narrowing and hardening of the retinal arteries.

Risk Factors

Risk factors for retinal vein occlusion include:

  • Advancing age – more than 50% of cases occur in patients over the age of 65
  • Systemic diseases such as hypertension (high blood pressure), high cholesterol, diabetes, smoking, obesity and symptoms of clotting disorder


Symptoms of retinal vein occlusion include:

  • Painless vision loss
  • Blurriness
  • Distorted vision


  • Laser treatment can be successful with branch retinal vein occlusion
  • Intravitreal injections such as Avastin, Triesence or other injectables
  • Intravitreal Ozurdex, Triesence, Lucentis, Avastin and Eylea

It is critical that the underlying systemic diseases are treated adequately by the primary care physician.


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