What is a lamellar hole?
A lamellar hole is a partial-thickness defect in the macula - the part of your retina responsible for fine detail in central vision. It’s often found during routine scans and may not always cause symptoms. This is different from a macular hole, which is a full break through all layers of the macula and more likely to cause noticeable central vision loss.
Some remain stable for years and require no treatment. Others may gradually worsen and begin to interfere with reading, driving, or using screens.
Lamellar hole symptoms
You might notice:
- Blurred or slightly distorted central vision
- Straight lines that appear wavy
- Difficulty with reading or detailed tasks
- Trouble recognising faces or using screens
Not everyone will have symptoms, and for many, they’re subtle. If you’ve noticed a sudden change in your vision, we recommend seeing a retinal specialist to assess whether lamellar hole treatment is necessary.
What causes a lamellar macular hole?
Lamellar holes often develop as part of normal ageing, when the gel inside the eye (vitreous) begins to pull away from the retina. They can also appear after cataract surgery, trauma, or alongside other conditions like epiretinal membrane (ERM) or macular degeneration.
Do all lamellar holes need treatment?
Not every lamellar hole needs treatment. Professor Williamson will assess the thickness, location, and progression of the hole to help you decide between monitoring and treatment.
You may not need surgery if:
- Your vision is stable
- The hole is not progressing
- It isn’t interfering with daily life
Treatment may be advised if:
- Vision is gradually worsening
- Distortion is affecting your daily activities
- There’s a risk of progression to a full-thickness macular hole
Professor Williamson will take time to explain all options clearly and help you decide on the best course of action.
“I appreciated his honest assessment, review of possible options and considerations and his judgement”
Keith B.
How do we treat lamellar holes?
Diagnosis: OCT and retinal assessment
At your appointment, Professor Williamson will carry out a full retinal examination, using:
- A high-resolution OCT scan to view the macula in detail
- Visual assessments to measure clarity and distortion
- A careful review of your symptoms and overall eye health
This allows us to understand the stage and severity of your lamellar hole and whether treatment is needed.
Lamellar hole treatment: What surgery involves
If surgery is the right option, you’ll be under the care of one of the most trusted retinal surgeons in the UK. Professor Williamson performs vitrectomy with membrane peel, a refined and effective operation to relieve traction on the macula and improve visual outcomes.
What to expect:
- A vitrectomy removes the vitreous gel to release traction
- A membrane peel removes a thin layer of tissue that may be distorting the macula
- A gas bubble will be placed to help the retina heal
This is typically a day-case procedure and can be performed under local or general anaesthetic.
Your recovery from lamellar hole treatment - what to expect
Our team will provide detailed aftercare and schedule regular follow-ups to monitor your recovery.
Surgery Time
~45–90 minutes
Hospital Stay
Gradual over days to weeks
Driving
Often 1–2 weeks (longer if gas bubble present)
Flying
Not permitted until the gas bubble has fully gone
Screen Use
Next day if comfortable
Light Activity
Next day
Full Recovery
Several weeks to a few months
Meet Professor Williamson
Professor Tom Williamson is one of the UK’s foremost retinal surgeons, practising in London. With over 40 years in the field, he has performed more than 20,000 operations and is recognised for both his meticulous technique and consistently successful outcomes. Known for his clear, pragmatic approach, Professor Williamson offers patients highly personalised care with continuity over the long term.
“I come for regular checks to meet with the Professor and I feel confident that I am under the care of an expert”
Anthony T.
“I appreciated his honest assessment, review of possible options and considerations and his judgement”
Keith B.
“He is a very skilled surgeon; I am truly grateful to him, and I would recommend him to anyone without a second thought”
Roger S.
What does lamellar hole treatment cost?
For self-funding patients, the cost of a vitrectomy for one eye is £8,898.
Insurance
We work with major insurance providers, including Bupa, AXA‑PPP, Vitality, WPA, and Aviva. As Professor Williamson is not a fee‑assured consultant, your insurer may not cover the full amount - we’ll confirm any costs with you before treatment.
Want to understand your options?
Speak to our team to book a consultation.
