Eye Health: Macular Holes

The macula is the centre of the retina and provides the central vision we need for tasks such as reading and seeing fine detail. A macular hole occurs when the vitreous separates from the centre of the retina or the macula. The vitreous causes traction on the macula, which can lead to a macular hole. This condition is often related to aging and is more common in women.

Causes & Symptoms of Macular Hole

Common causes of a macular hole include:

•High myopia (nearsightedness) 
• Injury or trauma to the eye 
• Diabetic eye disease 
• Retinal detachment 
• Macular pucker 

Symptoms of a macular hole include vision loss, blurry vision or a dark spot in your central vision. You may experience difficulties driving or reading, and objects may look wavy or bent. 

Treatment for a Macular Hole

If left untreated, macular holes will grow and vision will continue to decline. Rarely, a macular hole may heal on its own if the vitreous completely separates without any intervention. If the hole is small enough, the edges of the hole may find each other and close on their own. If your optometrist or ophthalmologist determines that you have a macular hole, you will likely see a vitreoretinal surgeon to discuss closing the macular hole and improving or stabilizing visual acuity. Pars plana vitrectomy is a common surgical procedure that has a 90 percent success rate, meaning that the macular hole closes and vision is improved or stabilized. Commonly after pars plana vitrectomy, the vitreoretinal surgeon places a gas bubble in the eye.

Following pars plana vitrectomy for a macular hole, the patient will be required to maintain a particular head position determined by the vitreoretinal surgeon. People who have had a macular hole in one eye have a higher chance of developing a macular hole in their other eye, so it’s important to see your eye doctor for regular eye exams.

Talk to your eye doctor if you'd like more information on macular holes. 

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Print this Action Plan and check off items that you want to discuss with your healthcare provider

• Common causes of a macular hole include high myopia (nearsightedness), injury or trauma to the eye, diabetic eye disease, retinal detachment and macular pucker.

• Symptoms of a macular hole include vision loss, blurry vision or a dark spot in your central vision.

• If your optometrist or ophthalmologist determines that you have a macular hole, you will likely see a vitreoretinal surgeon to discuss closing the macular hole and improving or stabilizing visual acuity.

• Pars plana vitrectomy is a common surgical procedure that has a 90 percent success rate, meaning that the macular hole closes and vision is improved or stabilized.

• People who have had a macular hole in one eye have a higher chance of developing a macular hole in their other eye, so it’s important to see your eye doctor for regular eye exams.

Adherence:
Adhering to your medications, prescribed exercises or lifestyle changes (such as dietary changes, smoking cessation, reduced alcohol consumption, etc.) is essential to improving health outcomes successfully. Compliance to any prescribed treatment is the number one thing you can do to ensure positive changes and optimal treatment outcomes.

  Healthy eyes depend on regular visits to your optometrist for eye exams, and if necessary, an ophthalmologist for certain eye conditions and surgeries like diabetic retinopathy . You can also protect your eyesight with proper nutrition, eating foods that contain the right vitamins. Local Optometrists may prescribe eyeglasses and contact lenses, provide laser eye surgery consultations, and test for diseases.  Local Ophthalmologist  can help with many facts of eye diseases. Getting a referral from your optometrist to a local ophthalmologist is crucial to eye care.