What is the Macula?
The retina is like the film of the eye and is the part that allows people to see. The macula is the center of the retina and allows people to see in the middle and read small print.
The simplest explanation for why macular holes develop is the vitreous jelly, which fills most of the eye, becomes liquid, shrinks, and separates from the back of the eye. Sometimes scar tissue can sometimes pull on the retina and cause a retinal hole. When the hole is in the center of the retina, it is called a macular hole and can affect the central vision. Lines may look wavy, missing, or bowed in the middle, and the vision can be blurry.
It is not common to develop a macular hole, but the risk increases with age (older than 60), being very near-sighted, or having a history of trauma or surgery. About 12% of patients can develop a macular hole in both eyes.
Treating a Macular Hole
Full-thickness macular holes affecting the vision may require surgery. A pars plana vitrectomy is where the vitreous gel is removed from the middle of the eye with small instruments; tissue on the surface of the retina that is causing traction may be peeled, and a gas bubble is placed in eye. Patients will position after surgery to help the hole close. Patients should avoid flying, travelling to high altitudes or scuba diving, or receiving nitrous oxide (laughing gas) with a gas bubble in the eye. Most patients experience an improvement after surgery, but the vision may vary depending on the size, duration, and healing of the macular hole. Smaller macular holes and not delaying surgery are associated with better vision.
