What is a macular hole?The macula is the small area in the center of the retina responsible for your central vision which helps you to perform tasks such as reading, driving and close-up work. A macular hole is a small break in the macula.
There are three stages of a macular hole:
- Foveal detachment (Stage I)
- Partial-thickness hole (Stage II)
- Full-thickness hole
Causes and Symptoms of Macular Hole
Macular holes typically affect people over age 55 and occur more often in women. Several conditions increase the risk of developing a macular hole:
- Vitreous traction: The vitreous is the clear, jelly-like substance that fills the middle of the eye between the lens and the retina. As you age, the vitreous can begin to pull away from the retina, sometimes causing a macular hole.
- Injury or trauma to the eye
- Diabetic eye disease
- High degree of myopia (nearsightedness)
- Retinal detachment
- Macular pucker
Symptoms of a macular hole can include:
- Decline in central vision
- Blurring of vision
- Distortion, causing straight lines to appear wavy
- A dark spot in your central vision
Ocular coherence tomography (OCT) is used for diagnosing, staging and managing a macular hole.
Treatment and Prognosis
The standard treatment for macular holes is vitrectomy surgery, an outpatient procedure that involves removing the vitreous gel to stop it from pulling on the retina. A gas bubble is then placed in the eye to push against the macular hole, helping it to close and heal. Over a period of several weeks, the gas bubble slowly dissolves and is replaced with natural eye fluids.
If a macular hole is very small and is not significantly impacting vision, your retina doctor may simply observe and track its progression or natural healing.