Macular Hole
Macular Hole
A macular hole is a small break in the macula, which is the central part of the retina — the light-sensitive tissue at the back of the eye. The macula is responsible for sharp, straight-ahead vision, which we use for tasks like reading, driving, and recognizing faces.
A hole in this area can lead to blurred or distorted central vision, and in advanced cases, even a dark or missing spot in the center of your vision.
What Causes a Macular Hole?
Macular holes usually occur with aging, especially in people over 60. The eye contains a gel-like substance called the vitreous. As we age, this gel shrinks and pulls away from the retina. If it pulls too hard, it can cause a hole to form in the macula.
Other causes may include:
- Eye injury or trauma
- Severe nearsightedness (high myopia)
- Retinal detachment
- Diabetic eye disease
- Previous eye surgery (e.g., for a detached retina)
Retinal Care
Symptoms of a Macular Hole
- Blurry or wavy central vision
- Straight lines appear bent (metamorphopsia)
- Difficulty reading or seeing fine details
- A small dark spot or missing area in central vision
- One eye may be worse than the other
Macular holes typically affect only one eye at a time.
How Is It Diagnosed?
Your eye doctor will perform:
- Dilated eye exam
- OCT scan (Optical Coherence Tomography): A painless imaging test that shows detailed layers of the retina and clearly confirms the presence of a hole.
Treatment Options
Unlike some other retinal conditions, a macular hole usually requires surgery to repair.
Vitrectomy Surgery
- The most common and effective treatment
- Involves removing the vitreous gel and placing a gas bubble in the eye to help the hole close
- Recovery involves keeping your head in a face-down position for several days
Without treatment, the hole can get bigger and central vision can worsen permanently.
What to Expect After Surgery
- Most patients regain part of their lost vision
- The earlier the treatment, the better the outcome
- You may need to avoid flying or traveling to high altitudes for several weeks after surgery (due to the gas bubble)
Frequently Asked Questions
Sometimes very small holes close by themselves, but most require surgery to restore vision.
No. Surgery is done under local or general anesthesia, and patients don’t feel pain during the procedure.
You won’t go completely blind, but central vision may become severely affected if left untreated.
It’s rare, but a macular hole can reopen. Regular follow-up is important.
Patient Guide Download
Want to read more? Download this trusted guide from the National Eye Institute:
Macular Hole
Macular Hole:
Vitrectomy Surgery