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Conditions

Macular hole

Macular holes are rare conditions affecting central vision, causing blurriness and distortion

On this page:
What is?
Symptoms
CAUSES
TREATMENTS

What are macular holes?

The macular hole is a condition that can blur the central vision you use to do everyday tasks such as reading and or driving. The macula is a small area in the centre of the retina, which is responsible for providing central vision, fine details and certain colours. A macular hole can happen when an opening forms in the macula – usually after being stretched or pulled. Most macular holes form because of changes to the eye that happen as you age.
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Symptoms

Patients with macular holes may initially experience blurry or wavy vision which can lead to loss or blurred central vision, visual distortions and difficulties seeing close-up objects clearly. Macular holes tend to get larger over time leading to increasing problems with vision. Common symptoms include:
  • Blurred and distored vision
  • Straight lines look wavy or bowed
  • Trouble reading small print
  • See a small black patch

Causes

Macular holes are typically caused by the natural ageing process and changes in the vitreous gel inside the eye. Some common causes of macular holes include:

As we age, the vitreous gel inside the eye may shrink and pull away from the macula (the central part of the retina). This can create tension on the macula and lead to the formation of a hole.

Severe trauma or injury to the eye can also cause a macular hole to develop.
People with high levels of nearsightedness are at a higher risk of developing macular holes.
In some cases, the vitreous gel may not completely detach from the macula, causing traction on the macula and leading to the formation of a hole.
In rare cases, a macular hole may be associated with a retinal detachment.
It is important to seek medical attention if you experience symptoms such as central vision distortion, blurriness, or a dark spot in the center of your vision, as these may indicate a macular hole or other retinal issues that require prompt treatment.

Treatments

Surgery for macular holes is highly effective, especially when carried out early. As with many eye conditions, spotting the signs of macular holes and promptly seeking treatment can lead to a better chance of a successful outcome.

Macular hole surgery (also known as vitrectomy) stops vision from getting worse in the majority of cases. Patients also report improved vision. 90% of surgeries successfully close the macular hole so that further treatment is not necessary.

Macular holes can be treated using keyhole surgery. This is a specialised kind of procedure in which the eye is operated on through a tiny opening. Usually, surgery for macular holes requires local anaesthetic. The procedure involves removing the vitreous gel from the eye and placing a small bubble of gas inside the eye. This helps to close the macular hole.

The eye will heal over a period of weeks. If a stitch is used to close the opening it will dissolve on its own within 6 – 8 weeks. A shield or patch can be used for one day after the surgery to protect it. Surgery offers the most effective treatment for macular holes and the best prevention from further vision loss. While vision will never be as clear as it was prior to the hole developing, it will stabilise and limit further vision loss.

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