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What is a macular hole?

The retina is a thin layer of nerve tissue that lines the back of the eye and gives you the ability to see, very much like the film of a camera. The macula is a specialised area of the retina that is responsible for seeing fine details clearly in the centre of your vision. The macula allows you to perform tasks like driving, recognising faces and reading small print. When you develop a hole in the macula (macular hole), you lose the ability to perform some of these fine vision tasks.

Symptoms of a macular hole

Usually, macular holes only occur in one eye at a time and present symptoms such as:

  • Distortion of images in the centre of your vision
  • Grey or black spot in the centre of your vision with normal surrounding vision
  • Inability to read, recognise faces or drive

What causes macular holes?

Macular holes most commonly develop due to the gel of the eye pulling on the retina in the area of the macula or due to diseases that cause damage to the macular tissue itself. Diseases most commonly associated with macular holes are:

  • Posterior vitreous detachment (Vitreous gel detaching from retina due to ageing)
  • Myopia (Nearsightedness)
  • Retinal detachment
  • Epiretinal membrane
  • Cystoid macular oedema

How are macular holes treated?

Surgery may be performed to close macular holes under local anaesthesia with sedation or general anaesthesia. A pars plana vitrectomy is performed where the gel on the inside of the eye is removed. The thin layer of tissue on the surface of the retina that keeps the macular hole open is also removed, and a gas bubble is placed on the inside of the eye. After your surgery, you should position face down so the bubble can float toward the area of the hole and help close it. This position is vital for adequate recovery. Surgery is effective in structurally closing the hole in 90% of cases, but vision improvement depends on the patient and the severity of the condition.


“Vision is the true creative rhythm”

- Robert Delaunay