Macular Fold: Can Surgery Improve Aniseikonia Symptoms?

Macular folds

I have been suffering from an eye condition for the past year, which has actually been developing for over 10 years.
My symptoms are known as aniseikonia, where the images seen by both eyes are of different sizes and distances.
It feels like I am wearing a poorly fitted pair of glasses all day, leaving me feeling dazed.
My right eye has a macular fold, causing the image to appear larger and closer than in my left eye.
My visual acuity is slightly less than normal, but the images are not distorted and there are no scotomas.
Is it possible that the macular fold is magnifying the image, resulting in the size discrepancy between my eyes? I believe the image from my left eye is correct.
Would surgery to remove the macular fold improve my condition? Thank you.

keith, 70~79 year old female. Ask Date: 2022/04/07

Dr. He Jianxian reply Ophthalmology

Macular folds can indeed cause image distortion or magnification or reduction of images.
To improve the condition, it is necessary to remove the membrane causing the macular folds, which requires surgical intervention.
This is for your reference.
Dr.
Ho Chien-Hsien, Ophthalmology Department, Nantou Hospital.

Reply Date: 2022/04/07

More Info

Aniseikonia, the condition where the same object appears different in size or shape to each eye, can be particularly distressing and is often associated with underlying retinal issues, such as macular folds. In your case, the presence of a macular fold in your right eye could indeed be contributing to the symptoms you are experiencing. The macula is responsible for central vision and any distortion or irregularity in this area can lead to significant visual discrepancies between the two eyes.

When the macula is affected by a fold, it can alter the way images are processed by the brain, leading to the perception of size differences. This is likely what you are experiencing, where the image from your right eye appears larger and closer than that from your left eye. The brain relies on the input from both eyes to create a cohesive visual perception, and when there is a discrepancy, it can lead to confusion and discomfort, often described as feeling like you are wearing poorly fitted glasses.

Surgical intervention to remove the macular fold could potentially improve your symptoms of aniseikonia. The goal of such surgery would be to flatten the macular area, thereby restoring a more normal shape and function to the retina. If successful, this could lead to a more uniform perception of size and distance between the two eyes, alleviating the discomfort you are currently experiencing.

However, it is essential to consider several factors before proceeding with surgery. The success of the operation depends on the specific characteristics of the macular fold, the overall health of your retina, and any other underlying conditions that may be present. Additionally, while surgery may improve the visual input from the affected eye, it does not guarantee that aniseikonia will be completely resolved. The brain's adaptation to the new visual input can vary from person to person, and some individuals may still experience discrepancies even after surgical correction.

Recovery from macular surgery typically involves a period of monitoring and follow-up appointments to assess the healing process and the effectiveness of the intervention. It is crucial to adhere to your ophthalmologist's post-operative care instructions, which may include restrictions on physical activity and the use of prescribed eye drops to prevent infection and reduce inflammation.

In conclusion, while surgery to address the macular fold may offer a potential solution to your aniseikonia symptoms, it is essential to have a thorough discussion with your ophthalmologist regarding the risks, benefits, and realistic expectations of the procedure. They can provide personalized advice based on your specific condition and help you make an informed decision about your treatment options.

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