The macula is a small area in the center of the retina that is responsible for our central vision. A macular hole is a defect, much like a buttonhole, that develops at the very center of the macula. It occurs when the clear gel that fills the eye, the vitreous, pulls on the retina and stretches open part of the macula into a hole. There are 4 stages of a macular hole, and if it progresses through each stage vision loss may worsen.
The early stage of a macular hole usually has no symptoms but as it progresses to other stages symptoms may include:
- Blurred and distorted vision
- Unable to see fine details when looking straight ahead
- Blind spot in central vision
Macular holes are uncommon and predominantly affect people over the age of 60. It can also be found in younger patients with trauma, diabetics, or patients with inflammatory disorders.
To diagnose a macular hole, our ophthalmologists will perform a dilated comprehensive eye exam along with necessary imaging tests such as an optical coherence tomography (OCT) to photograph the retina.
The most common treatment for a macular hole is a surgery called vitrectomy. A vitrectomy is an outpatient surgery performed under local anesthesia which typically takes less than an hour to complete. During the surgery, the vitreous is removed and replaced with a gas bubble to aid in closure of the hole. After the surgery, your doctor may ask you to position your head for a certain period of time to allow for successful healing. As the macula heals, vision will gradually return, though how much will depend on the severity of the macular hole.