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Pre-OP: 53-year-old woman was seen in the office on 5/20/2011. She had cataract surgery in June of 2009. She noticed the vision in the left eye was starting to get foggy some time around the middle of April (1 month ago). VISUAL ACUITY: Vision OD is 20/20, OS is 20/160. IOP: OD 17, OS 18. SLIT LAMP EXAM: The posterior chamber intraocular lens is in good position in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.5. There is a posterior vitreous separation. There is a lamellar macular hole. OS: Vertical C/D ratio is 0.5. There is a posterior vitreous separation. There is a full-thickness 800-micron macular hole. OCT SCAN: The OCT scan confirms the macular hole in the left eye, which is full-thickness, and the right eye, which is partial thickness. PHOTOGRAPHS: Photos confirm clinical findings. IMPRESSION: 1. LAMELLAR MACULAR HOLE – RIGHT EYE 2. FULL-THICKNESS STAGE IV MACULAR HOLE – LEFT EYE DISCUSSION: I explained to the patient with vitrectomy there is about a 90% chance of closing the macular hole in the left eye, presuming I peel the internal limiting membrane and use a long-acting gas bubble because it is a little bit bigger than average. 9 Months Post-OP: 53-year-old woman had vitrectomy for a stage IV macular hole in the left eye on June 1st. Her vision has improved some but still has a bump in it. VISUAL ACUITY: Vision OS is 20/80, PH is 20/60. IOP: OS 15. There is a posterior chamber intraocular lens in good position. EXTENDED OPHTHALMOSCOPY: OS: Vertical C/D ratio is 0.3. The fovea looks slightly irregular. OCT SCAN: The OCT scan confirms a closed hole. PHOTOGRAPHS: Photos confirm clinical findings. IMPRESSION: 1. CLOSED MACULAR HOLE – LEFT EYE DISCUSSION: I explained to the patient the macular hole is closed. Her vision is good, but not great, and I explained that there are very few patients with macular holes who develop completely normal vision when the hole closes. Considering she had a stage IV hole, she has actually done a little better than average. I think she will improve a little bit over the next year.

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Macular Hole - Stage 4126 views53-year-old woman was seen in the office on 5/20/2011. She had cataract surgery in June of 2009. She noticed the vision in the left eye was starting to get foggy some time around the middle of April (1 month ago).

VISUAL ACUITY: Vision OD is 20/20, OS is 20/160
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Macular Hole - Stage 4132 views53-year-old woman was seen in the office on 5/20/2011. She had cataract surgery in June of 2009. She noticed the vision in the left eye was starting to get foggy some time around the middle of April (1 month ago).

VISUAL ACUITY: Vision OD is 20/20, OS is 20/160
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Macular Hole Closed - Nerve Fiber Layer Defects Visible after Internal Limiting Membrane Peel - Vision 20/60146 views53-year-old woman had vitrectomy for a stage IV macular hole in the left eye on June 1st. Her vision has improved some but still has a bump in it.

VISUAL ACUITY: Vision OS is 20/80, PH is 20/60
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Macular Hole Closed - Nerve Fiber Layer Defects Visible after Internal Limiting Membrane Peel - Vision 20/60120 views53-year-old woman had vitrectomy for a stage IV macular hole in the left eye on June 1st. Her vision has improved some but still has a bump in it.

VISUAL ACUITY: Vision OS is 20/80, PH is 20/60
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Pre-OP: 53-year-old woman was seen in the office on 5/20/2011. She had cataract surgery in June of 2009. She noticed the vision in the left eye was starting to get foggy some time around the middle of April (1 month ago). VISUAL ACUITY: Vision OD is 20/20, OS is 20/160. IOP: OD 17, OS 18. SLIT LAMP EXAM: The posterior chamber intraocular lens is in good position in both eyes. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.5. There is a posterior vitreous separation. There is a lamellar macular hole. OS: Vertical C/D ratio is 0.5. There is a posterior vitreous separation. There is a full-thickness 800-micron macular hole. OCT SCAN: The OCT scan confirms the macular hole in the left eye, which is full-thickness, and the right eye, which is partial thickness. PHOTOGRAPHS: Photos confirm clinical findings. IMPRESSION: 1. LAMELLAR MACULAR HOLE – RIGHT EYE 2. FULL-THICKNESS STAGE IV MACULAR HOLE – LEFT EYE DISCUSSION: I explained to the patient with vitrectomy there is about a 90% chance of closing the macular hole in the left eye, presuming I peel the internal limiting membrane and use a long-acting gas bubble because it is a little bit bigger than average. 9 Months Post-OP: 53-year-old woman had vitrectomy for a stage IV macular hole in the left eye on June 1st. Her vision has improved some but still has a bump in it. VISUAL ACUITY: Vision OS is 20/80, PH is 20/60. IOP: OS 15. There is a posterior chamber intraocular lens in good position. EXTENDED OPHTHALMOSCOPY: OS: Vertical C/D ratio is 0.3. The fovea looks slightly irregular. OCT SCAN: The OCT scan confirms a closed hole. PHOTOGRAPHS: Photos confirm clinical findings. IMPRESSION: 1. CLOSED MACULAR HOLE – LEFT EYE DISCUSSION: I explained to the patient the macular hole is closed. Her vision is good, but not great, and I explained that there are very few patients with macular holes who develop completely normal vision when the hole closes. Considering she had a stage IV hole, she has actually done a little better than average. I think she will improve a little bit over the next year.