Macular Hole
What is a macular hole?
A macular hole is an uncommon eye disorder that can cause blurriness in the central vision you rely on for daily activities such as reading or driving.
The macula is a tiny region located at the center of the retina, which is the light-sensitive layer of tissue situated at the back of the eye. Macular holes occur when an opening develops in the macula, typically as a result of it being stretched or pulled. Most macular holes arise due to age-related changes in the eye.
Some individuals with macular holes may experience mild symptoms and might not require immediate treatment. However, if a macular hole is enlarging, worsening, or leading to significant vision issues, doctors may suggest surgery to safeguard your eyesight.
What are the symptoms of a macular hole?
If your other eye has good vision, you might not detect any symptoms from a macular hole. When symptoms do manifest, they usually begin gradually.
Initially, you may observe that objects appear distorted or blurry when you look directly ahead. Straight lines or objects, such as a window frame, may seem bent, wavy, or appear to be missing a section in the center. This can make it more challenging to perform everyday tasks like reading, writing, or driving.
As time progresses, you may notice a blurred or blind spot in your central vision. While reading, you might see the lines but overlook letters or words in the center. Alternatively, you may be able to recognize a person's face but not see their nose or eyes.
Early surgical intervention can often restore vision. Without prompt treatment, loss of central vision may become irreversible.
Is a macular hole the same as age-related macular degeneration?
No, macular holes and age-related macular degeneration can produce similar symptoms and are both prevalent among individuals over the age of 60, but they are distinct conditions. If you are uncertain about which condition you have, consult your eye care professional.
Learn more about age-related macular degeneration
Am I at risk for a macular hole?
If you have experienced a macular hole in one eye, you are at a higher risk of developing it in the other eye. Approximately 1 in 10 individuals who have a macular hole in one eye will also develop a macular hole in the opposite eye.
You are also at an increased risk for a macular hole if you:
Are 60 years of age or older
Are significantly nearsighted
Have suffered an eye injury or undergone eye surgery
What causes a macular hole?
In most cases, a macular hole occurs due to changes in your eye as you age.
As you grow older, the vitreous (the clear gel-like substance that fills your eye and maintains its round shape) shrinks and separates from the retina. This phenomenon is known as vitreous detachment, and it is a common occurrence for everyone as they age.
In some individuals, the vitreous remains more firmly attached to the macula, pulling on it as it detaches. This pulling and stretching of the retina can lead to the formation of a macular hole.
How will my doctor check for a macular hole?
Your eye doctor will assess for a macular hole by performing a test known as optical coherence tomography (OCT). This is a non-invasive test that utilizes light waves to capture detailed images of your retina.
Prior to the test, your doctor may administer eye drops to dilate (enlarge) your pupil.
What’s the treatment for a macular hole?
If a macular hole is impacting your vision, you will likely require a surgical procedure called vitrectomy to repair the hole and avert permanent vision loss.
During a vitrectomy, the doctor removes the vitreous and some tissues from the surface of the macula, then injects a gas bubble into your eye. This bubble acts as a temporary bandage that holds the edges of the macular hole together and assists your eye in closing the hole.
Following the surgery, you will need to restrict your activities and movements for a period of time. This is essential to keep the bubble in the correct position so that the macular hole can heal. Limiting head movement can be challenging, so it’s advisable to discuss with your doctor the best ways to recover from a vitrectomy. Additionally, you should avoid flying or receiving nitrous oxide (laughing gas) for any procedures until the bubble has completely dissipated, as these can influence the pressure within your eye.
Treatment is most effective when macular holes are detected early, so it is crucial to consult your eye doctor promptly if you experience any symptoms of a macular hole.