Macular Holes

What Are Macular Holes?

A macular hole is a defect in the macula, the part of the retina responsible for sharp, detailed central vision. The size of the hole and where it is located determines to what extent it will affect a person’s vision.

Symptoms of Macular Holes

The most common symptom of a macular hole is the decline in the central vision of the affected eye, leading to:

• Blurring
• Distortion of straight lines
• Dark spots

What Causes Macular Holes?

For the vast majority of cases of macular holes, there is no obvious cause. However, age is considered a factor in that macular holes most often affect those over 60 years of age. In addition, as we age, the vitreous gel of the eye loses volume and shrinks. If the vitreous sticks to the retina, the macula can stretch and cause a hole to form. There are also some cases of macular holes associated with eye injury or a retinal detachment.

Diagnosing a Macular Hole

Diagnosing a macular hole requires a comprehensive dilated eye examination so that the health of the macula can be assessed. It is also likely that an optical coherence tomography (OCT) will be performed. An OCT device scans the back of the eye to provide detailed images of the retina and macula.

What Are the Treatment Options for Macular Holes?

Evaluation by an experienced retina specialist is indicated for all macular holes. The most common treatment for macular holes is a surgery called vitrectomy, which involves the removal of the vitreous that is pulling on your macula. A gas bubble is then placed inside the eye, helping to close the macular hole to hold it in place while your retina heals. A macular hole that develops from an eye injury may initially be observed to determine if further treatment is necessary.