A macular hole is a break in the macula, which is the light-sensitive layer of tissue near the center of the retina. Because macular holes are related to aging, people over the age of 60 have the highest risk of developing this eye problem.

What is a macular hole?

The macula is a small part of the retina that contains light-sensitive cells. These cells are concentrated in the middle of the retina where the eye focuses the images that we see. When the vitreous fluid in the eye begins to shrink and separate from the retina, this can cause the nerve cells of the macula to pull away and separate. This is what is referred to as a macular hole, or retinal hole.

Symptoms of a macular hole

A macular hole can develop slowly or suddenly, and usually just one eye is affected. Some symptoms associated with macular holes include: 

• Blurred or distorted central vision 
• Blind spot in central vision
• Inability to see fine details

The initial symptoms of a macular hole can be alarming. Any abrupt change in vision can be a sign of a macular hole or another retinal disorder. Contact an eye care specialist if you experience any of the vision changes listed above.

Causes of a macular hole

The development of macular holes tends to be associated with aging. The holes are caused by shrinkage of vitreous fluid in the eye, which appears to be a normal change that occurs in the eyes as we age. The vitreous fluid becomes thicker and stringier with age, and eventually it simply pulls away from the retina, causing a hole or tear to develop.

In rare cases, macular holes can also be caused by an injury to the eye or a medical condition that affects the eye.

Treatment of a macular hole

Macular holes can sometimes resolve on their own, but in most cases, treatment is necessary to prevent vision loss. The most common and effective treatment for a macular hole is a vitrectomy. During this procedure, the vitreous gel is removed so that it will no longer pull on the tissue of the retina. The vitreous gel is replaced with a gas bubble that puts pressure on the edges of the macular hole until it is completely healed.

If you experience any change in your vision, be sure to visit your eye doctor as soon as possible.