Macular Hole

The macula is the part of the eye that allows you to see clearly and sharply. The macula also allows you to see detail. It is located inside the eyeball, in the center of the eye’s light-sensitive tissue (retina).

A hole in the macula affects how well you can see. Usually, only one eye has a macular hole. However, it is possible for both eyes to have a macular hole.

What are the causes?

The cause may not be known (idiopathic). Possible causes may include:

• The macula breaking down as part of the natural aging process.
• Eye injury.
• Extreme nearsightedness (high myopia).

What increases the risk?

You are more likely to develop this condition if you:

• Are female.
• Are older. The risk increases with age.
• Have a macular disease that is passed from parent to child (inherited), such as Best disease.

What are the signs or symptoms?

Symptoms may include:

• Blurry vision.
• Vision that makes things look misshapen (distorted).
• Difficulty doing things that require you to see details, like reading and driving.

How is this diagnosed?

This condition may be diagnosed based on:

• Your medical history.
• An eye exam. During the exam:
  • An eye specialist (ophthalmologist) may put drops in your eye to make your pupils bigger (dilation). This helps the specialist see your macula.
  • You may be asked to look at a series of crossed lines that form a checkerboard pattern (Amsler grid).
• A test that gives your health care provider a cross-sectional view of your retina (optical coherence tomogram).
• A test that checks for fluid collection in the area of the hole (fluorescein angiogram).

How is this treated?

Some macular holes may seal themselves and go away without treatment. Other holes may last a long time and even become permanent. Surgery to fix the macular hole (vitrectomy) is often needed.

Follow these instructions at home:

• Do not drive unless your health care provider approves.
• Ask your health care provider what activities are safe for you.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have new or worsening symptoms.

Summary

• The macula is the part of the eye that allows you to see clearly and sharply. A hole in the macula affects how well you can see.
• Surgery to fix the macular hole (vitrectomy) is often needed.
• Keep all follow-up visits as told by your health care provider. This is important.