The macula is the retinal tissue responsible for central vision; firmly attached to the macula is the vitreous gel that fills the center of the eye. With age, the vitreous begins to sag and shrink and separates from the retina. Sometimes this shifting pulls on the macula, causing a hole to form. Macular holes often develop suddenly. Full-thickness macular holes cause distortion or loss of vision in the affected area.
It is important to see a physician or ophthalmologist at the first sign of vision change. Early detection gives the best chance for restoring as much vision as possible. Macular holes are repaired with a vitrectomy surgery. 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. Facedown positioning for a time after surgery is considered important to maximize the chance of success. Greater than 90 percent of macular holes are successfully repaired, and most patients have some vision improvement. For more details, please see Treatment Options.