What It Is
A macular hole is a small break or gap that forms in the macula, the central part of the retina responsible for sharp, detailed vision.
How It Develops
A macular hole most commonly develops as part of a normal age-related process in which the gel-like substance filling the eye, called the vitreous, gradually shrinks and pulls away from the retina. In some cases, this pulling action can create enough tension on the macula to cause a small hole to form. Macular holes can also occur following eye injury or in association with certain other eye conditions.
General Symptoms
Common symptoms of a macular hole include blurred or distorted central vision, difficulty with tasks requiring detailed vision such as reading, and sometimes a dark or blank spot in the center of the visual field. Peripheral vision is generally not affected.
General Treatment Approaches
Small macular holes are sometimes monitored, since a portion may improve without treatment. Larger or persistent macular holes are commonly treated with a surgical procedure that removes the vitreous gel and helps close the hole, often followed by a temporary gas bubble placed in the eye to support healing.
Background
Macular holes were recognized as a specific retinal condition in the late 19th century, though the connection to the vitreous gel pulling on the macula wasn't fully understood until imaging technology advanced considerably in the latter half of the 20th century. The development of effective surgical repair techniques in the late 1980s and 1990s transformed outcomes for this condition, and success rates for closing macular holes surgically are now generally quite high.