Macular hole

Macular Hole

A macular hole is a small break in the macula, located in the center of the eye's light-sensitive tissue called the retina. The macula provides the sharp, central vision we need for reading, driving, and seeing fine detail. A macular hole can cause blurred and distorted central vision.

Causes

Macular holes are related to aging and usually occur in people over age 60. They are caused by the shrinking of the vitreous, which is the gel-like substance in the middle of the eye. This can pull on the retina and cause a hole in the macula. Other causes include diabetic eye disease, high myopia, macular pucker, and eye injury.

Symptoms

Symptoms of a macular hole can include:

• Decreased ability to see fine details, whether close or at a distance
• Distorted or wavy vision
• Difficulty reading or performing tasks that require seeing fine details
• Gray or black area in the center of vision

Diagnosis

A macular hole can be diagnosed through a comprehensive eye examination. This can include:

• Checking visual acuity, where the patient reads an eye chart to determine how well they can see letters from across the room.
• Dilating the eyes to allow a closer look at the retina.
• Performing a fluorescein angiography, where a special dye is injected into a vein in the arm and pictures are taken as the dye passes through the blood vessels in the retina.
• Performing an optical coherence tomography (OCT), which can capture detailed images of the retina and display them as cross-sectional views.

Treatment

The most common treatment for a macular hole is a surgical procedure called a vitrectomy. This involves removing the vitreous gel to stop it from pulling on the retina. A gas bubble is placed in the eye to help flatten the macular hole and hold the retina in place while it heals.

Prognosis

The success of treatment for a macular hole depends on its size and duration. Most people can expect a recovery of at least half of their lost vision, and some people may regain almost all of their vision. The recovery of vision can continue for up to three months following surgery.

See Also

• Retina
• Vitreous body
• Eye examination
• Vitrectomy