A macular hole is a small hole that forms in the macula. The macula is located in the center of the eye’s light-sensitive tissue called the retina. The macula provides sharp, central vision necessary for reading, driving, and seeing fine detail. 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.
When this occurs, if there is an unusual adhesion between the vitreous and the macula, the vitreous can pull on the retina, stretching the thin spot in the center until it opens up, forming a macular hole. Usually, no tissue is missing. Retinal specialists are trying to determine why macular holes occur and what can be done to prevent them.
In general, people do not go “blind” from macular holes. Even if surgery is not performed, it is reassuring to know that your side vision is almost always maintained.
The occurrence of a macular hole in one eye does not mean that the other eye will develop one. In fact, the chance of developing a macular hole in your good eye is probably less than 5%. Monitoring your Amsler grid on a daily basis will ensure early recognition of any changes in your good eye.
Treating a Macular Hole
Using microscopic instrumentation, we can surgically close more than 90 percent of macular holes with good results, which can either eliminate the black spot in the field of vision or reduce its size. Most patients note less distortion and a two- to three-line improvement in vision on the eye chart.