Definition: The vitreous gel inside the eye is firmly attached to the macula. With age, the vitreous becomes thinner and separates from the retina. Sometimes this creates traction (pulling) on the macula, causing a hole to form. A macular hole occurs for a variety of reasons including eye injuries, certain diseases, and, inflammation inside the eye. The most common cause is related to the normal aging process.

Symptoms: Macular holes often begin gradually and affect central vision depending on the severity and extent of the problem. Partial holes only affect part of the macular layers, causing wavy, distorted, blurred vision. Patients with full-thickness macular holes experience a complete loss of central vision.

The severity of the following symptoms depends on whether the hole is partial or full-thickness;

• Blurred central vision
• Distorted, “wavy” vision
• Difficulty reading or performing tasks that require seeing detail
• Gray area in central vision
• Central blind spot

Treatment: Rarely, macular holes seal spontaneously and require no treatment. In many cases, surgery is necessary to close the hole and restore useful vision. The surgery consists of a vitrectomy to remove the vitreous gel, eliminating traction on the macula. The eye is then filled with a gas bubble to place gentle pressure on the macula and help the hole to seal. In many cases, patients enjoy functional vision after the bubble has dissipated and the eye has healed.