What is a macular hole?
A macular hole is a circular hole that occurs at the macula (the fine vision area), in very centre of the retina.
What symptoms does a macular hole cause?
A macular hole most commonly causes a blurred or black spot right in the center of your vision. It also can cause distortion and difficulties in depth perception.
What causes it?
Most macula holes occur due to aging, as the vitreous separates from the retina. Traction (pulling) on the central retina results in a “gap” in the retina at its most sensitive location. Occasionally they can be associated with short-sightedness (myopia) or trauma.
How is it diagnosed?
Macula holes can be diagnosed by clinical examination and optical coherence tomography (OCT) scans.
What is the management?
Unfortunately most full-thickness macular holes won’t resolve by themselves. Vitrectomy surgery in a hospital is needed in most cases. This involves specialised key-hole eye surgery. The vitreous jelly and a thin membrane on the surface of the retina are removed. A gas bubble is then inserted into the eye, which usually will dissolve by itself over approximately 2 weeks. After the operation you may be asked look down for a few days. Whilst the gas bubble is in your eye you cannot fly on an aeroplane or go to high altitudes. Macular hole surgery is very successful, with an average closure rate for the hole of over 95% in most cases.