Macular Holes

The macula is the central area of the retina that is extremely important for your central sight. A macular hole is a serious defect in this tissue that causes a distortion or even blind spot in your central vision.

How Does a Macular Hole Form?

Your eye is filled with a gel-like substance called the vitreous. This vitreous lies in front of the macula. As you age, the vitreous gel shrinks and pulls away from the macula, and usually separation occurs from the retina without a negative effect on your retina other than some new floaters. However, in some cases the vitreous sticks to the macula and is unable to pull away when it contracts. As a result, the macula tissue is stretched and distorted. After this process begins, within weeks or months, the macula tissue can tear, forming a hole. Sometimes trauma can precipitate this process, making it happen quickly.

What are the Symptoms of a Macular Hole?

In the early stages of hole formation, your central vision becomes blurred and distorted. If the hole progresses, a blind spot will form where the tissue has been pulled away from the retina. Since the macula is used for near and far vision, both are affected but reading more profoundly.

Remember, if the macula is the only tissue involved, you will not lose your vision completely. The only area of vision affected by this disease is the central vision, so your side vision will remain intact.

What Tests will be Performed by My EyeMd to Diagnosis and Treat This?

Your ophthalmologist at The Kaufman Eye Institute will diagnose a macular hole by looking inside your eye with special lenses at a biomicroscope. At that time your doctor will order an Ocular Coherence Tomography (OCT), to scan and examine your retina. OCT use light waves to reveal specific layers of the retina. Sometimes a fluorescein angiography is run to look for leakage in or around the retina.

How is a Macular Hole Treated?

The most effective treatment to repair a macular hole is vitrectomy surgery. This complex surgery involves tiny instruments to remove any vitreous gel that is pulling on the macula. After that is done, the eye is filled with a special gas bubble to flatten the hole and hold it in place while it heals.

After this surgery you must maintain a face-down position to keep the special gas bubble in place. This can range from a few days to several weeks. The result is largely dependent on the patient's ability to remain with good positioning as the bubble dissolves on its own.

Flying is not allowed during this period of healing until your eye doctor deems it is safe. As the macular hole closes the eye will slowly regain part of the lost sight. The amount of visual recovery will vary depending on how long the hole was present and the size of the hole.