A macular hole is a small break in the macula, the central part of the retina responsible for sharp, detailed vision. It can lead to blurred and distorted central vision.
Most commonly, macular holes occur due to age-related changes in the vitreous gel inside the eye. Other causes include trauma, high myopia, or previous eye conditions.
Macular holes are usually classified in stages (early to advanced) based on their size and severity.
Most macular holes require surgery (vitrectomy) to close the hole and improve vision.
Surgery involves removing the vitreous gel, relieving traction on the macula, and placing a gas bubble inside the eye to help close the hole.
Surgery is highly successful, with closure rates of over 90% in many cases, especially when treated early.
Face-down positioning helps improve surgical success, but alternatives may be discussed depending on individual cases and surgical techniques.
Without treatment, the macular hole may enlarge, leading to worsening and permanent central vision loss.
The surgery is usually performed under local or general anesthesia and typically takes about an hour. Most patients can go home the same day or the next day.
Initial recovery occurs over a few weeks, but visual improvement may continue for several months.
