Macular Hole

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Overview

When someone with a macular hole tries to look at a letter, a part of the letter can appear missing.

Macular hole is an age-related condition that can develop in patients with age > 55. If you have a macular hole, you may notice blurred vision with one eye. If you try to cover the unaffected eye and read with the affected eye, you may notice some letters missing or distorted. Macular hole occurs because of abnormal vitreous gel aging over the macula. A macular hole can be repaired by vitrectomy, an outpatient surgical procedure.

macula hole

Causes

Macular hole is caused by abnormal aging of the vitreous gel. The very center of the macula is very thin and delicate. The aging vitreous gel somehow pulls in a wrong direction and causes a tiny rip in the macular center. Over the subsequent weeks, the tiny rip gets bigger and a full-thickness macular hole develops.

There are other causes for macular hole, such as a severe eye injury, or near-sightedness. But most commonly, macular hole is due to abnormal aging of the vitreous gel.

Treatment

Most macular hole needs vitrectomy surgery for repair. During surgery, the vitreous gel tissue around the macula hole is cleared away to relieve the pulling forces on the hole. A gas bubble is put into the eye to help close the hole. As the eye heals, the gas is naturally replaced with aqueous fluid inside the eye. While the gas bubble is in the eye, you can help the hole close by keeping a face-down position for a few days. The degree of visual improvement after surgery is based on the severity and the duration of the condition, and is often very satisfactory. While there is any gas bubble in the eye, you must not go on an airplane trip or undergo any other surgical procedure that uses gas.