What is a Macular Hole?

A Macular Hole is a hole (“macula”) in the central area of the retina that may increase in size over time, causing gradual loss of vision.

What are the symptoms?

As Macular Hole is a degenerative disorder, it may be relatively asymptomatic in the early stages. The symptoms include image distortion and difficulty performing routine tasks, such as reading or driving.
If the Macular Hole is not detected early on, and continues to develop, a “black spot” will eventually appear on the central axis of vision, leading to loss of central vision. Since the macular hole affects only the central part of the retina, the peripheral vision will remain within the normal range.

What are the causes of a macular hole?

Age is the most common cause of macular holes. As we get older, the vitreous humor (a jelly-like viscous substance that makes up about 80% of the eyeball) contracts and detaches from the macula. Normally, this separation occurs without any problems, however on certain occasions, it may lead to the formation of a macular hole.
Other risk factors include:

• Ocular trauma
• Eye inflammation
• Other eye diseases, such as diabetic retinopathy or retinal detachment

How is a macular hole diagnosed?

A macular hole is diagnosed after examination of the ocular fundus by the ophthalmologist, and through optical coherence tomography (OCT). OCT enables confirmation of the diagnosis and provides important anatomical information for the surgery.

What is the treatment?

A macular hole is treated through a retinal surgery called a vitrectomy. This is a procedure that involves removing the vitreous and internal limiting membrane and replacing it with a gas that forms a tamponade, closing the macular hole.
The earlier the diagnosis and treatment, the better the restoration of vision.