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.
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.
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.
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.
Keeping on Top of Your Condition
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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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