During the healing process, the eye makes fluid that gradually replaces the gas and fills the eye. Gas is often injected to into the eye to replace the vitreous and reattach the retina the gas pushes the retina back against the wall of the eye. Next, a small instrument is placed into the eye to remove the vitreous, a gel-like substance that fills the center of the eye and helps the eye maintain a round shape. During a vitrectomy, the doctor makes a tiny incision in the sclera (white of the eye). If necessary, a vitrectomy may also be performed. In some cases a scleral buckle, a tiny synthetic band, is attached to the outside of the eyeball to gently push the wall of the eye against the detached retina. Retinal detachments are treated with surgery that may require the patient to stay in the hospital. Cryopexy freezes the area around the hole and helps reattach the retina. During laser surgery tiny burns are made around the hole to "weld" the retina back into place. These procedures are usually performed in the doctor's office. Small holes and tears are treated with laser surgery or a freeze treatment called cryopexy. Macular holes can also occur from eye disorders, such as high myopia (nearsightedness), macular pucker, and retinal detachment eye disease, such diabetic retinopathy and Best's disease and injury to the eye. In either case, the fluid that has replaced the shrunken vitreous can then seep through the hole onto the macula, blurring and distorting central vision. This increases tension on the retina and can lead to a macular hole. Also, once the vitreous has pulled away from the surface of the retina, some of the fibers can remain on the retinal surface and can contract. However, if the vitreous is firmly attached to the retina when it pulls away, it can tear the retina and create a macular hole. Some patients may experience a small increase in floaters, which are little "cobwebs" or specks that seem to float about in your field of vision. In most cases, there are no adverse effects. Natural fluids fill the area where the vitreous has contracted. As we age, the vitreous slowly shrinks and pulls away from the retinal surface. The vitreous contains millions of fine fibers that are attached to the surface of the retina. Most of the eye's interior is filled with vitreous, a gel-like substance that fills about 80 percent of the eye and helps it maintain a round shape.
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