Macular hole

By Medically reviewed by hellodoktor


What is macular hole?

A macular hole is a condition that occurs when there is a small break in the macula, located in the center of the eye’s light-sensitive tissue called the retina. The macula plays a vital role in the sharp, central vision we need for reading, driving, and seeing fine detail. A macular hole affects the vision you use when looking directly at something, such as a book or the TV. Instead of seeing obviously your vision can become blurred and distorted or there can be a black or blank spot in the center of your view.

A macular hole can cause blurred and distorted central vision.

How common is macular hole?

Macular holes are related to aging and usually occur in people over age 60. It is a painless condition which can happen without warning. Only one eye is normally affected but there is a 10% chance that your other eye could be affected in the future. A macular hole does not lead to total sight loss as peripheral vision is not affected. Please discuss with your doctor for further information.


What are the symptoms of macular hole?

The common symptoms of macular hole are:

  • Slight distortionor blurriness in the straight-ahead vision
  • Bent or wavy lines and objects
  • Difficulties reading and performing daily tasks

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consulting with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.


What causes macular hole?

It is not known precisely why macular holes develop and most of them have no obvious cause. However, it is known that it is mainly slightly long sighted people who are affected. Other causes include:

  • Severe injury to the eye
  • As a result of longstanding swelling of the central retina (cystoid macular oedema)
  • Being very short sighted (myopic)
  • Having had a retinal detachment
  • Vitreomacular traction

When the vitreous jelly in the eye starts to shrink and pull away from the retina and macular at the back of the eye.

Risk factors

What increases my risk for macular hole?

There are many risk factors for macular hole, such as:

  • Female gender
  • Old age
  • A history of eye disorders, such as high myopia (nearsightedness), injury to the eye, retinal detachment

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is macular hole diagnosed?

If your doctor suspects that you may experience this condition, a physical examination will be performed and some tests will be also recommended by your doctor. During an eye exam, your doctor will dilate your pupils and examine your retina. You may have a test called fluorescein angiography that uses dye to illuminate areas of the retina.

Another test called optical coherence tomography (OCT) is considered as the most helpful in making an accurate macular hole diagnosis. With OCT, a special diagnostic laser camera is used to photograph your retina. It measures the thickness of the retina and is also very sensitive at detecting swelling and fluid. OCT can also diagnose small macular holes that are too small to be seen in an examination or with angiography.

How is macular hole treated?

If macular hole is left untreated, vision will get worse until a patient is unable to read even the largest print on the eye test chart.

Though some macular holes can seal themselves and require no treatment, surgery is important in many cases to help enhance vision. In this surgical procedure, called a vitrectomy, the vitreous gel is removed to avoid it from pulling on the retina and replaced with a bubble containing a mixture of air and gas. The bubble acts as an internal, temporary bandage that holds the edge of the macular hole in place as it heals. Surgery is performed under local anesthesia and often on an out-patient basis.

Following surgery, patients must remain in a face-down position, normally for a day or two but sometimes for as long as two-to-three weeks. This position allows the bubble to press against the macula and be gradually reabsorbed by the eye, sealing the hole. As the bubble is reabsorbed, the vitreous cavity refills with natural eye fluids.

Maintaining a face-down position is crucial to the success of the surgery. Because this position can be difficult for many people, it is important to discuss this with your doctor before surgery.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage macular hole?

The following lifestyles and home remedies might help you cope with macular hole:

  • Wearing protective eyewear when playing sports or using tools
  • If you are diabetic, control your blood sugar and see your doctor regularly.
  • Get regularly eye exams, especially if you have risks for macular hole.

It is essential to know the symptoms of macular hole. Recognizing when you may have an eye problem and seeking medical care immediately can save your vision.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

msBahasa Malaysia

Review Date: August 22, 2017 | Last Modified: September 12, 2019

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