Living through the bubble

This is the story of my macular hole, vitrectomy and new lens

A few months ago at the end of February 2025 I woke up feeling a bit odd. My sight was a bit off, with some blurry and distorted vision. I put it down to some sort of visual migraine, something I experience now and then. I continued on with my day, hoping to sleep it off overnight.

The next morning it was still there. I tried shutting one eye and then the other and I realised through my left eye, wherever I looked my world was distorting and there was a big dark grey patch over everything.

I called the optician, who got me in to have a look that morning. They took photos of the inside of my eye, and could clearly see a hole in my macular. As suspected, he confirmed it was most definitely a macular hole. He explained that the sooner it is treated, the better the chance of a good outcome. He referred me to Torbay hospital, and I took the bus home. I still wasn't driving as I was still in a splint, recovering from having two screws and a bone removed from my wrist,

I was looking forward to driving again in a few weeks time but this news scuppered any hope of that in the near future.

What is a macular hole? 

As a photographer, I know our eyes are the most sophisticated of cameras, in fact so complex that no camera could ever come close.. Some unlucky people develop a hole in the very centre of their retina, the centre being the part where we see detail. The retina at the back of the eye is like our inbuilt photographic film or these days, the sensor at the back of the eye, which sends signals to our brain - our sight.

There was a clear gap in my macular which coats the retina. This is referred to as a macular hole.  A macular hole causes an area of central blurring of vision with the distortion of vision. Straight lines become kinked and wavy. Faces distort in a wierd horror-film way. And daily life is tiring as the good eye and the macular hole eye are in constant conflict. It also makes looking people in the eye difficult. I kept thinking everything I looked at was dirty - the eqivalent of adding a dark grey layer in photoshop, at about 60% opacity.

If left untreated these horrible distortions would only get worse over time.

How did the macular hole form?

Between the lens of the eye and the sensor/retina at the back, the eye is filled with a clear jelly called vitreous. This jelly pulls at the centre of the retina, pulling the tissues apart to create the hole.

The treatment - a vitrectomy.

Most people who have a vitrectomy develop a cataract with in a year, and I had the start of one forming, so the plan was also to have a new lens put in my eye at the same time.

May 2025 and I was booked in to Torbay hospital ophthalmology eye surgery unit at 7.30am

I am not in general a squeamish person. I had complete faith in the surgeon, and did not feel stressed about the actul operation, so I did not need a general anaesthetic or sedative.

On the morning of the op, after reporting in to the Eye Surgery Unit at Torbay, after a host of drops in my eye, measurements and tests I was ushered into the anaesthetic room. The anaesthetist was great, and explained everything he was doing. I think he liked that as he said most people are not interested and prefer to be knocked out!

I was in there for about half an hour. Drops, followed by injections. I didn't feel a thing. The eyeball was anaesthetised, but not anything around it. My eyelids and face were unaffected. When i was asked to look to the side, the good eye looked but the numb eye just stayed put. It must have looked so weird.

Eventually I was wheeled into the operating theatre. A sheet was placed over my good eye and the process began. I could only see blurry colours. The process took about an hour and a half. I started asking questions, like "What is that machine doing?". The surgeon calmly said "I think it's better that I tell you after we've finished." Well that shut me up and I thought I'd better just let him concentrate! The sounds and colours were fascinating. I could feel movement, a bit of pressure but not much else. The machines made noises of different notes, and some were quite musical. The worst part was getting a stiff neck.

The actual vitrectomy and other things

This is what I had done to my eye, taken from my letter and with a bit of help from google.

• A left limiting membrane peel A surgical procedure to remove scar tissue from my macula.

• Internal tamponade.I had the jelly in my eye sucked out and replaced with gas. The gas bubble would support my retina after the surgery and hold it in place.

• Pars plana vitrectomy (PPV) The surgeon removed the gel-like substance in my eye through a small incisions in the white of my eye.

• Phacoemulsification This used ultrasound to break up and suck out the clouded lens of my eye. A clear artificial lens was implanted to replace the natural lens. In other words this was cataract surgery.

• Retinopexy A laser was used to seal any retinal breaks or tears, preventing retinal detachment. This was done by applying laser burns around the break, creating scar tissue that reinforces the retina and prevents it from detaching.

Going home...

As soon as I got home, as well as a complicated regime of various eye drops, I had to "posture" for five and a half days. This meant looking only downwards, my nose to the floor, with just ten minutes an hour allowed for looking up, stretching, going to the loo, and doing life. I was well prepared with everthing I needed within easy reach, straws for drinking, a long queue of movies on the iPad.

Looking down lets the gas bubble float at the top of the eyeball, and uses gravity to help try to push the edges of the macular hole together.

The bubble gradually shrinks over four to six weeks as the eye refills itself. It has been one of the most oddest experiences of my life. It is as fascinating as it is difficult to live with.

I am now on day 12 after my surgery and plan to continue to write up illustrated experiences of the gas bubble in my eye as it gradually shrinks.

There is very little on google about what it actually looks from within looking out, so I've been creating illustrations of the experience in photoshop.

This is about all I can manage to write now. I'm closing the good eye to do this. The whole thing is exhausting - I'm feeling extremely tired from it and still a bit disorientating, and slightly unsteady on my feet.

Just before my operton

I have to wear this until the bubble has completely gone

The first evening home, looking down through the massage chair

The next day after my checkup at the hospital

Once i was up again I found this a useful way to get around

me with a dilated eye at my checkup

Photoshop recreations of what my eyes sees as time goes on

So that I don't forget this most bizarre experirence of having a bubble in my eye, I decided to recreate as accurately as I can the varous stages of vision through the bubble.

This was the view through my gas bubble once I had finished the days of looking downwards (referred to as 'posturing').. It wobbles about with every movement I made, and is like having a built-in spriit level and having a huge microscope in my eye if I hold anything within an inch of it. Looking out, the view is pinched and dark. The dots in the area above the bubble are like mini floaters, at first like starlings in their thousands, and now like swarms of gnats infront of me everywhere I go, a bit like watching a 3D movie sensation. I keep wanting to swat them out of the way. I can't quite focus on them. They are just debris in the jelly and will go eventually. Things up close are magnified about five times as big at the y are. My fingers look giant!

Looking through the gas bubble after a vitrectomy, looking down a the floor

Looking up at the sky

In the garden and there were so many black specs always in view above the bubble. They reminded me of the starlings that swirl in the sky in their thousands just before coming in to roost.

Day 10 after surgery and this is what my operated on eye saw when trying to do stuff on the laptop The annoying gnats hovering in the air always in view have started to recede

I'm told that because there were tiny stitches needed, my eye would feel scratchy for a couple of weeks and although the drops have worked wonders, I still have a continual feeling as if there's a bit of grit in there. I hope this will be gone in the next few days. I might name my bubble Bob, or Michael Bublé or Michael Bubbley? Any other ideas?

Day 11 and I can now see above the slightly shrinking bubble. This is what reading looks like with both eyes open.

Day 11 and if I look down at my feet, the bubble now just about fits itself into view, proving it is shrinking well. The colour through the bubble is less charcoal and a bit more accurte. The lovely russet red at the edge is dependant on the direction of light.

I am now 14 days in, and the bubble has shrunk to about just over half of my vision. Using both eyes at once is more tiring and confusing than ever. It is making typing, reading, watching tv and using my phone diffficult. The specs in the air above the bubble are getting smaller and less intrusive and colours are less dark within the bubble. I am looking forward to the day when I can get back to my photography! Mostly I photograph wildlife and natre, and occasionally people.

15 days since surgery - a post-checkup update

I have just come back from Torbay Hospital with mixed feelings.

After reading the eye chart, where my bad eye could only just about read the top letter, the stingy eye drops to enlarge my pupil and a trip to the imaging room for a scan, I saw one of the consultants.

The eye is doing as expected at 15 days post surgry. He said it is still agitated and swollen inside and that it will take between three and six months to properly settle down and recover. It is still sore and scratchy when I blink, so i was given yet another set of drops.

Looking at the scan, he could see macular hole is partially closing but he could not tell me if what I am seeing now is how I will see out of that eye forever, or if it will gradually improve over the next three to six months.

The before and now scan of my macular hole

I am pleased that it is looking as it should at two weeks since surgery, but worried that this will be it now - I really can't contemplate living permanently with it is as it is today.

This is how my phone looks through both eyes. The focus area is always out of view.

This is how my phone looks through both eyes. The focus area is always out of view.

I will be seen again in a few weeks so for now I'm determined to remain positive.