Understanding Macular Holes: What They Are and How They're Treated
Originally published by Retinal Consultants Medical Group
Our vision depends on a delicate, finely tuned structure in the back of your eye called the macula. The macula is the central part of your retina, responsible for straight-ahead, sharp, detailed vision used for tasks like reading or recognizing faces. A macular hole is a small break in the center of the retina that disrupts sharp, central vision.
What Causes Macular Holes?
The shape of our eyes is supported by the vitreous, a clear, jelly-like substance that fills the space between the lens and the retina. As we age, the vitreous naturally becomes more watery and starts to shrink. Sometimes, parts of it remain stuck to the retina and tug on the center—the macula—even as the rest pulls away. Over time, this traction can be strong enough to create a small opening called a macular hole.
Risk Factors and Symptoms of Macular Holes
Because macular holes are most often caused by age-related changes in the eye, people over 60 face the highest risk. However, other risk factors include
- Being female (Macular holes appear to be more common in women)
- Having had eye trauma or injury
- Severe nearsightedness
- Eye inflammation
- Having had eye surgery
Common symptoms patients report include:
- Blurriness right in the middle of vision
- Distorted lines—straight lines might look bent or wavering
- A small dark or gray spot in the central vision
- Difficulty reading small text
If you notice any of these visual changes, it’s important to seek care right away. Macular holes rarely heal on their own, and early treatment gives you the best chance of closing the hole and preserving vision.
Treatment for Macular Holes
The most common way to repair a macular hole is a procedure called a vitrectomy. During this surgery, the vitreous is carefully removed so it no longer tugs on the macula. A small gas bubble is then placed inside the eye to gently press against the macula, which helps the edges of the hole to come together and close.
Over the next several weeks, the bubble slowly dissolves and is replaced by the eye’s natural fluids. While it is in place, vision is blurry, and patients are usually asked to spend the first few days in a face-down position so the bubble stays against the macula. Although this positioning can be challenging, it is a key part of the healing process.
Protecting Your Central Vision
Macular holes can feel frightening, but the good news is that with prompt diagnosis and treatment, many people experience significant improvement in their vision. If you’ve noticed changes to your vision, don’t wait to see if it goes away on its own. Schedule an appointment with our retina specialists today and take the first step toward protecting and restoring your vision.