What Is a Macular Hole?
At the center of the retina is the macula, which is responsible for the clear, central vision we need to read fine print, perceive facial features and distinguish fine details. A macular hole is a small tear or break in the macula that can cause visual distortion and blurriness.
Most macular holes occur when the vitreous, the gel-like substance that fills the middle of the eyeball, shrinks and pulls away from the retina; if the vitreous sticks to the retina, the pulling or tugging can stretch the macula and cause a hole or tear to form. Fluid can then pass through the opening, causing central vision to blur and distort. Other causes of macular holes include traumatic eye injuries and macular swelling from other eye diseases.
At Berks Eye Physicians & Surgeons, our team has extensive experience diagnosing and treating macular holes. If you have a macular hole, we will work promptly to help you recover clear, sharp central vision.
Macular Hole Symptoms
- Decline in the ability to clearly distinguish fine details, small print and facial features
- Dark spots in the central visual field
- Straight lines or objects appear wavy
Macular holes vary in size. The larger the hole, the greater the chance of visual impairment. The location of the hole also influences the impact on visual clarity.
Risk Factors for Macular Holes
- Age – most macular holes occur in adults over the age of 60
- Previous retinal detachment or retinal tear
- High degree of nearsightedness
- Blunt trauma to the eye
Macular holes occur more often in women than men. If you have a macular hole in one eye, there is a 10 to 15 percent chance you will develop one in the other eye.
Due to the fact that most macular holes are linked to age-related changes in the vitreous, there is no effective way to completely prevent them.
Diagnosing Macular Holes
Diagnosing a macular hole requires a comprehensive inspection of the retina. An imaging test called optical coherence tomography is used to scan the retina and provide detailed cross-sectional pictures of the retina and macula. These images are then closely examined for problems affecting the retina and macula.
Vitrectomy for Macular Hole Treatment
Some macular holes are very small and close on their own. For those that do not, a procedure called vitrectomy may be recommended. During vitrectomy, the vitreous tugging on the retina is removed from the eye and replaced with a gas bubble. The pressure from the gas bubble holds the edges of the macular hole in the correct position as the macula heals. Gradually, the gas bubble is absorbed and the eye replaces it with natural fluids.
Vitrectomy Recovery and Results
Maintaining a face-down position for a week (sometimes longer) is important after vitrectomy, as it helps keep the gas bubble in contact with the macula so the eye can heal. Our team will give you a specific timeline and helpful tips for maintaining a face-down position during your recovery.
As the macular hole closes, vision should gradually recover. However, it is possible that vision may not return to what it was before the hole formed.
Contact Us Today
Dr. Guri Bronner, our retinal specialist, handles cases of macular holes at Berks Eye Physicians & Surgeons. He has advanced fellowship training in diseases affecting the vitreous, retina and macula. If you have been diagnosed with a macular hole or are experiencing macular hole symptoms, please request a consultation with him today.