My Journey and Vision Recovery from Macular Hole Surgery
Joy R. Efron, Ed.D.
Many VisionAware readers have written to me, asking about my vision recovery. It is over fourteen years since my vitrectomy surgery for a full-thickness macular hole in my left eye. It takes more than a year for maximum recovery. I am extremely fortunate.
The visual acuity in my left eye has been 20/25 without glasses and 20/20 with glasses for many years. I wear my glasses only to drive at night or read small print in dim light. Any horizontal distortion is so minute that it is inconsequential. There is no image size disparity between my two eyes.
Eight Years Later: Dry Eye and a Macular Pseudohole
I have had dry eyes, which is a common condition, especially with age, and had to use eye drops for the dryness. Read more about my journey with dry eyes. However, surgery and the drops used during the recovery period after surgery can reveal other eye problems or worsen existing dry eye syndrome. My doctor also put me on glaucoma eye drops because of a reaction I had to the dry eye drops following my macular hole surgery.
Macular Hole
I was one of the people who ended up with a problem in the second eye. In 2012, three years after the vitrectomy on my left eye, I had similar surgery on my right eye for macular pseudohole. Please monitor your second eye carefully and see your ophthalmologist promptly if you notice any change in your vision.
I inquired about preventive surgery for a pseudohole, due to my concern that it might become a macular hole. I was informed that most retinal surgeons are not willing to perform a vitrectomy for a pseudohole when visual acuity is good and there is minimal visual distortion due to concerns about surgical risks and complications. These risks can include retinal detachment, cataracts, and macular edema (swelling or the accumulation of fluids in the macula). Consequently, my surgery was delayed and my vision had deteriorated by that time.
I now measure 20/30 in my right eye (without glasses) but, as far as I am concerned, this is not a functional vision measurement. There is some central vision blurriness with tiny blind spots in that eye. As a result, my brain has to fill in missing elements from letters or words. Using context clues, this does not present a problem with familiar material. It is definitely a problem with unfamiliar information, such as a series of random numbers, as in a telephone number.
While the acuity measures well for distance vision in my right eye, it would be difficult to read using that eye alone. It is difficult to determine details with the right (pseudohole) eye. For example, near my home there is a street called Hillhurst. In looking at the word, “Hillhurst,” you will see six consecutive vertical lines. There is no way I can count those lines with my right (pseudohole) eye. Fortunately, my left eye is dominant, and the brain selects that image.
Worsening of a cataract is a very frequent consequence of a vitrectomy. During the interval after my surgeries, vision deteriorated in each eye as cataracts progressed. Following cataract surgery, my vision recovery was remarkable.
[Medical editor’s note: Although often referred to as “cataract development,” people who have absolutely no cataract do not develop one after uncomplicated vitrectomy surgery. However, if there is the slightest pre-existing cataract, even one that is not affecting vision at all or one that was not discussed with the patient as a prior diagnosis, then it will definitely worsen from vitrectomy surgery.]
Also see Suggested Resources for more information about helpful products and organizations, as well as the author’s contact information.
A Disclaimer
I was an educator of blind and low-vision children for 42 years. Although I have read and researched a great deal and have had extensive discussions with retinal specialists, I am not an ophthalmologist or a medical doctor.
Reviewed by Mrinali Patel Gupta, M.D., VisionAware Medical Consultant. Updated by Author August 2023