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Macular Hole Fact Book



Table of Contents

Other Names

Macular cyst, retinal hole, retinal tear, and retinal perforation.

What is a macular hole?

The macula is a tiny oval area made up of millions of nerve cells located at the center of the retina. The retina is the light-sensitive tissue at the back of the eye. The macula is responsible for sharp, central vision. A macular hole is just that: a hole in the macula.

image of the eye

What causes a macular hole?

The eye contains a jelly-like substance called the vitreous. Shrinking of the vitreous usually causes the hole. As a person ages, the vitreous becomes thicker and stringier and begins to pull away from the retina. If the vitreous is firmly attached to the retina when it pulls away, a hole can result.

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What are the symptoms of a macular hole?

The size of the hole and its location on the retina determine how much it will affect vision. Generally, people notice a slight distortion or reduction in their eyesight. However, if the hole goes all the way through the macula, you can lose a lot of your central and detailed vision.

Is a macular hole the same as macular degeneration?

No, they are two different diseases even though they have similar symptoms. An eye care professional will know the difference.

How is a macular hole treated?

A surgical procedure called vitrectomy is often used to treat holes that go all the way through the macula. The vitreous is removed to prevent it from pulling on the retina. It is replaced with a gas bubble that eventually fills with natural fluids.

Following surgery, patients must usually keep their faces down for two or three weeks. This position allows the bubble to press against the macula and seal the hole.

Vitrectomy can lead to complications, most commonly an increase in how fast cataracts develop. Other less common complications include infection and retinal detachment either during surgery or afterward.

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How successful is this surgery?

The surgery is about 90 percent effective in closing the hole. However, improvement in people's vision is more variable. More than half of those who have the surgery can expect an improvement of two lines or more on the vision chart.

Is my other eye at risk?

Very few people get a macular hole in the second eye. Your eye care professional will be able to talk to you about your risk.

Research

Research studies are being conducted to determine other treatments for macular holes. Currently the research is looking at using silicon oil to close the macular hole instead of the gas bubble that is being used now. No definite conclusions have been reached at this time.

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Keeping on Top of Your Condition

Keeping in tune with your disease or condition not only makes treatment less intimidating but also increases its chance of success, and has been shown to lower a patients risk of complications. As well, as an informed patient, you are better able to discuss your condition and treatment options with your physician.

A new service available to patients provides a convenient means of staying informed, and ensures that the information is both reliable and accurate. If you wish to find out more about HealthNewsflash's innovative service, take the tour.

Other Resources

The following organization may be able to provide additional information on macular holes:

American Academy of Ophthalmology
P.O. Box 7424
San Francisco, CA 94120-7424
(415) 561-8500
Distributes a fact sheet on macular hole for patients.

For additional information, you may also wish to contact a local library.

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