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Overview
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The gas bubble
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How does the bubble affect vision?
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Head positioning
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What to expect
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When
does the vision improve?
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Postoperative instructions
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Postoperative medication
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Frequently asked questions
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How
do I get more information?
Macular hole surgery is unique because the outcome is not only dependent on the
surgeon's skill, it requires the commitment of the patient afterward.
During surgery, a gas bubble is placed inside the eye. The bubble puts gentle
pressure on the
macula and helps
the hole to seal. In order to enjoy the benefit of the surgery, it is imperative
that the bubble floats against the macula during the critical healing phase.
Since the gas rises, this is only possible when the head is in a face-down
position. Obviously, it is impossible to remain face-down 100% of the time;
however, each moment spent in this position increases the likelihood of
successful surgery.
When the bubble is first injected, it nearly fills the eye. This obstructs
vision for the first few weeks following surgery. Over time, the bubble
gradually dissolves, and vision improves. As the bubble gets smaller, it
sometimes breaks up into several smaller bubbles. This is common and does not
pose a problem. The outcome of the surgery cannot be determined until the bubble
begins to disappear.
It is important to remain face-down as much as possible for 9-10 days after
surgery. While this may seem a bit awkward, there are several things activities
that can be done in this position. Many patients read a book or magazine while
looking down. The non-operated eye will not suffer from overuse or strain.
Some
patients watch television by placing it face-up on the floor. An alternative is
to place a mirror in order to see a reflection of the television screen when
looking down. Other activities that can be done while sitting and looking down
are perfectly acceptable.
At times, the positioning may be uncomfortable; but a successfully closed hole
and improved vision is well worth the temporary aggravation.
The eye is patched after the first postoperative checkup. This can usually be
removed the same evening at bedtime. Since the anesthesia numbs the lids and
temporarily prevents blinking, it is very important to keep the eye patch on
until you are able to blink the eye normally. Begin using drops after the patch
has been removed.
How should the eye feel?
It is common to experience some discomfort immediately after the surgery and for
several days afterward. This is primarily related to swelling on the outside of
the eye and around the eye lids. A scratchy feeling or occasional sharp pain is
normal.
Ice compresses gently placed on the swollen areas (ice placed inside a
resealable plastic bag work well) reduce the aching and soreness.
If you have a deep ache or throbbing pain that does not respond to Tylenol or
other over-the-counter pain medication, please call your doctor.
Redness is common and gradually diminishes over time. Some patients may notice a
patch of blood on the outside of the eye. This is similar to bruising on the
skin and slowly resolves on its own.
Until the gas bubble has cleared, your vision will be very poor. In some cases,
it may take several weeks for the bubble to clear completely. You will notice
your vision slowly returning as the bubble clears.
While taking the dilating drop (red cap) the pupil of the operated eye will be
quite large and you may be light sensitive. This drop makes more room for the
gas bubble by keeping the pupil dilated. It also keeps the eye more
comfortable.
Following surgery, patients are examined the same day or the following
morning.
1. Keep the eye patched until later in the day when you are able to blink the
eye lids normally.
2. Begin taking medications as directed after the eye patch has been removed.
3. If you experience aching or soreness immediately after surgery, gently place
ice compresses on the eye. Tylenol is also helpful for minor aching and
soreness.
4. Wear the plastic eye shield when sleeping for the first 7 days after surgery.
It should also be worn when showering for the first 3 days after surgery.
5. The eye is most susceptible to infection for the first 7 days after surgery.
To minimize the risk, avoid touching, rubbing, or bumping the eye.
6. Avoid air travel until the gas bubble has completely dissipated from the eye.
This is important because the gas expands at high altitudes and could elevate
the eye pressure to a dangerous level. Please check with your surgeon to be sure
that the bubble is gone before flying.
7. Most importantly: Keep your head in a face-down position for 9-10 days
following surgery. This can be done while sitting or lying down.
Most patients take three different eye drops after surgery. The eye drops serve
several purposes such as: preventing infection, reducing swelling inside the
eye, reducing redness, and keeping the eye comfortable. The dilating drop with
the red cap keeps the pupil very large and causes light sensitivity. Consult
your written instructions for a list of medications and appropriate dosage.
During your follow-up visits, you will receive instructions how to gradually
reduce the frequency of the drops and eventually stop them all together.
Q: Will I get at least a partial benefit from the surgery if I can't keep my
head down?
A: The success of macular hole surgery is largely dependent your ability to keep
your head in a face down position. This positions the gas bubble correctly on
the macula, where it can maintain constant gentle pressure. This is critical for
the hole to seal closed and for your vision to improve.
Q: Why
do I feel that I'm looking through water?
A: This sensation comes from looking through the gas bubble. Your vision may
also seem "wavy" from the movement of the bubble inside your eye.
Q: How
soon after surgery will my vision improve?
A: Initially after the operation, your vision will be obstructed by the gas
bubble. As the bubble slowly dissipates over a period of weeks, you will begin
to see an improvement in your vision. Many patients continue to notice a gradual
improvement for several months after surgery.
Q: Should
I use my eye drops in any particular order?
A: The order the drops are used is not significant. However, in order to get the
full benefit of the medication, be sure to space the drops at least 5 minutes
apart so one doesn't wash out the other.
Q: How
can I eat, drink and bathe with my head down?
A: Using a straw is the best way to drink with your head down. Other activities
such as eating and bathing should be planned for 5-10 minute breaks that you can
take every hour.
There are several ways of reaching the ophthalmologists of EYE REPUBLIC Ophthalmology Clinic:
Hover note: Please place your mouse cursor over the red box
to click on the web and email links. For websites, a new browser
window will open. For emails, your default email program will
open. You may cut and paste the URLs or email addresses if you
prefer not to open new windows.
ONLINE ACCESS
WEBSITES.
http://www.EyeRepublic.com.ph - EYE REPUBLIC
Ophthalmology Clinic
http://www.OCP.com.ph - Ophthalmic
Consultants Philippines Co. -
http://www.LASIK.com.ph - Refractive
Surgery Resource
http://www.Cataract.com.ph - Cataract Surgery Resource
http://www.Eye.com.ph - Eye
Information Online
http://www.EyeDoc4Kids.com.ph - Eye Information for Kids
http://www.Retina.com.ph - Retina
Surgery Resource
http://www.Glaucoma.com.ph - Glaucoma
Online
http://www.Uveitis.com.ph - Uveitis Online
EMAIL. After writing down your comments,
suggestions, problems and/or questions, kindly tell us how
to get in touch with you by providing your name, email,
home/office numbers, and mobile phone.
General inquiries - help@EyeRepublic.com.ph
Refractive Surgery Service - refractive.surgery@EyeRepublic.com.ph
Glaucoma Service - glaucoma@EyeRepublic.com.ph
Cataract Service - cataract@EyeRepublic.com.ph
Doctors - eyemd@EyeRepublic.com.ph
Administrative - president@EyeRepublic.com.ph
Website - webmaster@EyeRepublic.com.ph
Newsletter -
newsletter@EyeRepublic.com.ph (receive
news and updates, discounts and promotions)
BLOG. Send us your comments.
EYE REPUBLIC
Ophthalmology Atlas
CLINIC INFORMATION
Mobile E-Yellow Pages. Via
SMS, text LUK4 EYEREPUBLIC
(send to 2851 for Globe and Sun Cellular, and 2951 for Smart). |
EYE REPUBLIC Ophthalmology Clinic
Manila
3/F Don Santiago Building Units 309-310
1344 Taft Avenue, Ermita
Manila, 1000 Philippines
Direct and Fax: (632) 536-2398
Trunk Line: (632) 523-8271 to 79 local 30
Mobile: (63917) 899-2020
Map and directions
|
EYE REPUBLIC
Ophthalmology Clinic
Asian Hospital
and Medical Center
5/F Medical Office
Building (MOB) Suite 509
2205 Civic Drive,
Filinvest, Alabang
Muntinlupa City,
1781 Philippines
Direct:
(632) 771-9253
Direct and Fax:
(632) 771-9254
Mobile: (63917) 795-2020
Map and Directions
|
EYE REPUBLIC Ophthalmology Clinic
Medical City
6/F Medical Arts Tower Inc (MATI) Suite 602
MERALCO Compound, Ortigas Avenue
Pasig City, 1604, Philippines
Direct and Fax: (632) 632-7846
Mobile: (63917) 537-2020
Map and directions
|
EYE REPUBLIC
Ophthalmology Clinic
St. Luke's
Medical Center
6/F
Cathedral Heights Building Complex (CHBC)
North Tower Suite 614
279 E. Rodriguez
Sr. Boulevard
Quezon City, 1102
Philippines
Direct and Fax:
(632) 407-3883
Mobile: (63917) 855-2020
Map and directions
|
CLINIC HOURS
First-Come, First-Served
Monday to Saturday 9:00 AM to 6:00 PM
All clinics are closed on Sundays and Holidays
|
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MACULAR HOLE SURGERY information compiled
by
Dr. Edmin Michael G. Santos and initially uploaded on May 1, 2005.
Last updated on
September 14, 2007. |
