A macular hole is a problem that develops in the central part of vision or the macula. The most common cause of a macular hole is posterior vitreous traction. The posterior vitreous (clear, gel-like substance in the center of the eyeball), as part of the aging process can partially separate. Sometimes this separation can cause traction or pulling on the retina, thus causing a hole to form.

Holes form gradually and affect vision in varying degrees depending on the severity of the problem. Some patients may only experience blurry, distorted vision while others may have a total loss of central vision.

Signs and Symptoms
blurry or distorted central vision
gray or black area in central vision
inablity to perform tasks requiring detail vision

Diagnosis
A dilated fundus examination will be performed to evaluate the macula. In addition, a fluorescein angiogram or optical coherence tomogram will most likely be performed as well.

Treatment
While some holes will close on their own, in most cases surgery is necessary to close the hole and restore useful vision. During surgery, a vitrectomy is performed to remove the gel in the eye. Then, a gas bubble is injected to "splint" the edges of the hole and help it to close. After the surgery, you will be required to maintain "face-down positioning." You can read about face-down positioning here.

Visit the National Eye Institute for more information on macular holes.

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