Figure 1. OCT of a full-thickness macular hole. Image: Betty Wills (Atsme), Wikimedia Commons, CC BY-SA 4.0. Source
What is it?
A macular hole is a small, full-thickness hole in the macula, the center of the retina that you use for reading and seeing faces. It happens when the gel inside the eye pulls on the center of the retina as it separates with age. It causes blurry or distorted central vision, sometimes with a missing spot in the middle. It is different from age-related macular degeneration.
What do I do about it?
Most holes need surgery to close. I do a vitrectomy, peel a very thin layer from the surface of the retina to release tension, and place a gas bubble that holds the hole closed while it heals. You may need to keep your face down for several days. You cannot fly, go to high altitudes or have nitrous oxide anesthesia until the bubble is gone. Most holes close with one surgery, and vision improves over several months. A cataract may develop afterwards.
When should I call?
Call my office the same day at 408-540-3559 if you notice:
- Pain, redness or worsening vision after surgery
- A shadow or curtain over part of your vision
- Nausea or a severe eye ache
- New distortion or a central spot in the other eye
This page is for general education and does not replace an exam. Call Cai Retina at 408-540-3559 with questions.