Retinal Diseases

Treatment of Macular Hole

Macular hole

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A macular hole is a small break in the macula, the tissue near the center of the eye's retina that's responsible for central vision. Macular holes usually occur in patients (more commonly women) over 60 years old. Most macular holes require surgical repair.

Holes can occur when the vitreous gel that fills the center of the eye begins to sag and shrink and separates from the retina. Sometimes, this shifting pulls on the macula, causing a hole to form.

Macular holes can develop gradually or suddenly. Early signs are slight distortions or blurriness in straight-ahead vision. A blind spot develops in the central vision as the hole progresses.

Macular holes are repaired with a vitrectomy. During the surgery, a gas bubble is placed in the eye. The bubble pushes on the macula when the patient looks down, and allows the hole to heal. After surgery, most patients must maintain a facedown position for 10 days to two weeks to allow the bubble to press against the macula, sealing the hole.

With this approach, more than 90 percent of macular holes are successfully repaired. Most patients have some vision improvement. Vision recovery can take up to three months after surgery. For more details, see treatment options.