The macula is the portion of the central retina responsible for our sharpest vision. A healthy and functioning macula is necessary for reading, driving and recognizing faces and fine details. A macular hole is not the same thing as macular degeneration. It does not involve scar tissue, abnormal vessels or atrophy. Instead, it is a small round opening in the retina located in the center of vision, the macula. This hole causes a blind spot or missing spot in the central vision. Sometimes it may simply result in blurring of vision or distortion of objects viewed.

Macular Hole

How are macular holes treated?

The only proven treatment for macular holes is vitrectomy surgery. Vitrectomy is performed with small microsurgical instruments that are inserted into the eye through small incisions. The vitreous humor (natural gel-like substance that fills the eye cavity) is carefully removed, along with any additional tissue coating the surface of the retina that may prevent the hole from closing. A long-acting gas bubble is placed in the eye to help the hole close, and the patient must maintain a face-down position for one to two weeks to keep the bubble in contact with the macula. The bubble gradually dissipates on its own. With surgery and strict face-down positioning, most holes close, but the degree of visual improvement can be variable. In general, the longer the hole has been present, the more variable the chances of visual improvement. It is important to know that even though vitrectomy surgery can repair the majority of macular holes, it can never restore vision to a completely normal level.