What is a Macular Hole?
A macular hole is when a tear or opening forms in your macula, the center of your retina that helps you clearly see details of objects in front of you. As the hole forms, things in your central vision will look blurry, wavy or distorted. As the hole grows, a dark or blind spot appears in your central vision. A macular hole does not affect your peripheral (side) vision.
Who is at Risk for a Macular Hole?
The following factors increase your risk of a macular hole:
• Age — as you get older, the vitreous, the clear, jelly-like substance that fills the center of your eyeball, begins to shrink and pull away from the retina. Usually, the vitreous pulls away with no problems. But sometimes the vitreous can stick to the retina. This causes the macula to stretch and a hole to form.
• An eye injury
• A swollen macula from another eye disease
Treatment and Prognosis
The primary treatment for a macular hole is to perform a vitrectomy. This procedure uses a tiny incision in your eye to remove the clear, jelly-like substance that fills the center of your eyeball (vitreous gel). Once the gel is removed, a gas or silicone oil bubble will be placed in the eye to help flatten the macular hole and hold it in place while your eye heals. This is performed in a surgery center or hospital using local or general anesthesia.
You cannot fly in an airplane until the gas bubble is gone. This is because elevating quickly in altitude can make eye pressure rise. That can cause problems with the bubble. Eventually, the gas will be absorbed, and the vitreous space will refill with body fluid. If silicone oil was used, it may be surgically removed months later.
Your vision will improve as the macular hole closes. It may take up to several months for the hole to close, depending on the size of the macular hole.
