Vision Impairment by Choice: Why Do Patients Decline Macular Hole Surgery?

Introduction: Vision care providers generally assume that patients who are affected with treatable vision impairment are interested in appropriate medical options. It has been our clinical experience, however, that approximately 10% of macular hole (MH) patients opt to decline surgery, even though its beneficial effects have been well established. They, thereby, choose to remain visually impaired in the affected eye. The present study investigated visual acuity in the unaffected eye, living distance from the hospital, and the presence of other age-related medical conditions as possible factors in the decision-making process of seniors affected with MH. Method: Thirty patients (aged 59–81 years) who declined treatment between 1998 and 2003 were matched on age and gender with a group of patients who chose the surgical intervention during the same time period. Information from their medical files was used for statistical comparison. Results: The groups did not differ statistically with regard to acuity in th...