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Macular Hole




What is a macular hole?


Macular hole is when an opening forms in the center of the macula, the fine detail portion of the central retina. As the hole forms, things in your central vision will appear blurry, wavy, or distorted. As the hole enlarges, you may develop a dark or blind spot in the center of the vision.


What causes a macular hole?


Age is the most common cause of a macular hole. As you get older, the vitreous begins to shrink and pull away form the retina. Usually the vitreous pulls away without causing a problem. Occasionally the vitreous stretches the retina enough to cause a hole to form centrally.


Macular holes can also form when the macula swells from other eye diseases, or following injury.


How is a macular hole diagnosed?


Your ophthalmologist will perform a medical exam of the eye following dilation. Special pictures called optical coherence tomography (OCT) will provide detailed images of the central retina. These scans allow for the visualization of a cross-section of the retina.














                                           Normal OCT                                                                                               Macular Hole


How is a macular hole treated?


Vitrectomy surgery is the best option to treat a macular hole. At the time of surgery, the vitreous is removed followed by the insertion of a gas bubble. This bubble flattens the macular hole “pushing” it together while the eye heals. The gas bubble then dissolves on its own.


Things to know about vitrectomy for macular hole:

  • You may have mild discomfort

  • Following surgery, face down positioning is required for successful macular hole closure

  • You cannot fly in an airplane until the gas bubble has completely dissolved (6-8 weeks)

  • Immediately following surgery, the vision is poor due to looking through the gas bubble. As the bubble dissolves, vision then improves. It may take several months before the final vision is known. How vision recovery is obtained depends on the size of the macular hole and how long it was present prior to surgery.


What are the risks of macular hole surgery?


Like any surgery, vitrectomy has risks, including but not limited to:

  • Infection

  • Bleeding

  • Retinal detachment

  • Glaucoma (elevated eye pressure)

  • Cataract

Click on the following link to the American Academy of Ophthalmology EyeSmart page for more information:




(*the above information was adapted from the handout "Macular Hole, Patient Education”, provided by the American Academy of Ophthalmology)


Retinal Associates of Oklahoma
Retinal Associates of Oklahoma
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