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Facts about Macular Hole | SK Retina


What is a Macular Hole?

A macular hole is a small break that develops in a sensitive portion of your retina called the macula.  The macula provides sharp and detailed central vision.  We use this vision for fine focus and detailed work.  Daily tasks like reading, driving, and watching TV use the macula.


What are the Symptoms of a Macular Hole?

Your vision may become blurred, wavy, or distorted.  Sometimes, patients notice an area of their central vision is completely missing while reading or at the computer.  Holes can be large or small so symptoms can be variable.  Some are found on routine eye examinations at the eye doctor during visual acuity testing.

Your ophthalmologist will use a dilated eye exam in the eye clinic to determine if you are suffering from a macular hole.  Eye photography or optical coherence tomography (OCT) can help determine the size, stage, and configuration of your hole.  An OCT is common tool used in the retina specialist’s office.  Important factors to note by the retina specialist are hole size, scar tissue around the macular hole, and degree of tension on the edges of the hole.


What causes a Macular Hole?

This is a much discussed topic in ophthalmology.  The most common risk factor is increasing age.  Most retina specialists believe it occurs as a result of forces exerted on the retina by the vitreous gel which shrinks and condenses over time.  Holes can also form as a result of eye trauma, high myopia, or after cataract surgery.


Can a Macular Hole Heal Itself?

Some holes do actually close spontaneously; however, these cases are rare.  Observation is rarely recommended as holes do not typically close without appropriate treatment and can get larger.  Retina specialists recommend vitrectomy with membrane peeling as the best way to treat a macular hole.  This surgery removes the vitreous gel from the eye and reduces the pulling forces on the edges of the hole.  Removal of the internal limiting membrane, a thin piece of tissue on then retina surface, has been shown to aid hole closure along with the use of intraocular gas.  After surgery, the gas is absorbed naturally and helps support the retina as it heals.  You cannot fly in an airplane until the gas bubble in your eye is fully dissolved.  Face down positioning after macular hole surgery is a controversial topic in ophthalmology and best discussed with your eye doctor in person.  Maximal improvement may take several months and depends on many factors about the state of the hole prior to vitrectomy surgery (size, shape, time present, retina changes around hole, prior eye surgery).


SK Retina in Sarasota, Florida can help you if you are experiencing symptoms of a macular hole.  If you would like to discuss if macular hole surgery can help your eye, contact Dr. Stelton today at 941-777-5000.


Learn More About Macular Hole

Can my Macular Hole be Fixed?

November 27th, 2017 by Chris Stelton

What are the symptoms of a macular hole? The macula is a critical portion of the retina responsible for our central vision and fine focus. We use the macula to read, look at our iPhones, and recognize familiar faces. Rarely, a hole can develop directly in the macula, which immediately causes a blind spot in… Read More.