All about Macular Hole

Macular Hole

If a hole develops in the central macula area of the retina, it often requires surgery to repair the damage and prevent further visual loss.

What causes a macular hole?

Most cases happen spontaneously. The exact cause isn't well understood, but it tends to start after the age of 60, and is more common in women. Some retinal holes are associated with retinal detachment, eye injury, being very short-sighted, or 'cystoid macular oedema' (CMO, a fluid swelling of the central retina).


What symptoms should I look out for?

Blurred or distored vision, or a black spot or missing patch in the centre of the vision can all be signs of a macular hole. If you notice any of these symptoms you should seek immediate medical attention as early treatment often leads to a better outcome.


How are macular holes treated?

Retinal surgeons use a 'vitrectomy' procedure with inner limiting membrane peel and gas to repair macular holes. Most people will experience an improvement in vision following surgery, especially if the hole was identified early.


What is the success rate of this operation?

This depends on the exact stage of the hole and how long it's been there. Most people with holes of less than one year's duration can expect at least two lines of visual improvement on a standard letter chart, and a reduction in visual distortion. Around half of patients with early, short duration holes can expect to see more than half way down a standard letter chart, and about a third achieve near normal vision.