Macular Hole

A macular hole is a retinal disease that occurs in the most sensitive part of the retina. This disorder can develop as part of the natural aging process as the vitreous shrinks and pulls on its membrane, tearing a hole in the macula. A macular hole may also be caused by:

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  • Eye trauma
  • Retinal detachment
  • Diabetic eye disease
  • Best's disease
  • Macular pucker
  • Extreme myopia
  • Extreme inflammation of ocular tissue

The symptoms of a macular hole are generally limited to a sudden decrease in visual clarity and the formation of a dark spot at the center of the field of vision. This will usually occur in one eye only; it is exceedingly rare to develop macular holes in both eyes that manifest at the same time. Although this is not considered a medical emergency, an appointment with your doctor is highly suggested should you experience any significant visual symptoms.

Excluding rare instances, the macular hole does not drastically impact vision and can be ignored so long as the symptoms do not worsen. It is more likely, however, that the doctor will recommend surgery to repair the macula. This is treated through a vitrectomy and intraocular injection of a filler gas that takes the place of the vitreous. The patient will need to maintain a face-down position for 10 to 14 days in order for the gaseous material to reassert the macula effectively. If performed and followed up properly, this is a reliable surgery with a success rate of over 90%.


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