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Macular Holes

What is a Macular Hole?

A macular hole is a small break in the macula. The macula is located in the center of the eye’s light sensitive tissue, the retina. A macular hole can cause blurred and distorted central vision because the macula is responsible for sharp, central vision required for driving and reading.

Cause of a Macular Hole?

Macular holes commonly affect people over the age of 55. Most macular holes develop spontaneously and is related to aging. Women are also at higher risk than men.

Macular holes may occur due to:

  • Best’s disease
  • Diabetic eye disease
  • Eye trauma
  • Myopia
  • Macular pucker
  • Retinal detachment
  • Vitreous shrinkage and/or separation

Are There Different Stages of a Macular Hole?

Yes, macular holes occur in three stages.

  • Foveal detachments (Stage I). Without treatment, about half of Stage I macular holes will progress.
  • Partial-thickness holes (Stage II). Without treatment, about 70 percent of Stage II macular holes will progress.
  • Full-thickness holes (Stage III)

How is a Macular Hole Treated?

Some macular holes may resolve themselves but surgery may be necessary to improve vision. An ophthalmologist may perform a vitrectomy to remove the vitreous gel and prevent it from pulling on the retina. The gel is replaced with a bubble consisting of air and gas to help the macular hole heal.

Following surgery, it is important that the patient remains in a face-down position for up to two weeks. This will help the bubble press against the macula and be reabsorbed by the eye to seal the hole. The vitreous cavity then refills with natural eye fluids.

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