Macular hole

Why does it happen?

We don't know why macular holes develop. The vast majority of cases happen spontaneously (without an obvious cause). They most often affect people aged 60-80, and are twice as common in women as men.

One possible risk factor is a condition called vitreomacular traction. As you get older, the vitreous jelly in the middle of your eye starts to pull away from the retina and macula at the back of the eye. If some of the vitreous jelly remains attached, it can lead to a macular hole.

A few cases may be associated with:

retinal detachment when the retina begins to pull away from the blood vessels that supply it with oxygen and nutrients
severe injury to the eye
being slightly long-sighted (hyperopic)
being very short-sighted (myopic)
persistentswelling of the central retina ( cystoid macular oedema )

Medically Reviewed by a doctor on 21 Dec 2018

Articles for macular hole

Introduction

A macular hole is a small gap that opens up at the centre of the retina in the macula. It causes blurred and distorted vision, and can be treated with surgery.

Why does it happen?

We don't know why macular holes develop. The vast majority of cases happen spontaneously (without an obvious cause). They most often affect people aged 60-80, and are twice as common in women as men.

What should I do?

If you have blurred or distorted vision, or there's a black spot in the centre of your vision, see your GP or optician as soon as possible. You'll probably be referred to an ophthalmologist (a special

What is the treatment and how successful is it?

Vitrectomy surgery A macular hole can often be repaired using an operation called a vitrectomy, withinner limiting membrane (ILM) peel and gas. If you've had the hole for less than a year, there's a

What does vitrectomysurgery involve?

Macular hole surgery is a form of keyhole surgery performed under a microscope. Three small incisions (one millimetre in size) are made in the white of the eye and very fine instruments are inserted.

macular-hole-expect-operation

Temporary poor vision With the gas in place, the vision in your eye will be very poor a bit like having your eye open under water. Your balance will be affected and you'll have trouble judging dista

Do I need to position myself face down after the operation?

Once at home, you may have to spend several hours during the day with your head held still and in a specific position, called posturing. The aim of lying or sitting face down is to keep the gas bubbl

Am I able to travel after macular hole surgery?

You must not fly or travel to high altitude on land while the gas bubble is still in your eye (up to 12 weeks after surgery). If you ignore this, the bubble will expand at altitude, causing very high

What if I need another operation shortly after my treatment?

Ifyou need a general anaesthetic while the gas is still in your eye, it's vital you tell the anaesthetist, so they can avoid certain anaesthetic agents that can cause expansion of the bubble.

Can I drive after the operation?

No the gas bubble will still be present in your eye for six to eight weeks after your surgery, so during this time you can't drive a vehicle of any sort. None of these exclusions apply once the gas h

How much time will I need off work?

Most people will need at least two weeks off work, although this will depend to an extent on the type of work you do and the speed of recovery. Discuss thiswith your surgeon.

What are the possible complications of macular hole surgery?

It's unlikely that you'll suffer harmful effects from a macular hole operation. However, you should be aware of these six possible complications: Failure of the hole to close. This happens in 1-2

How successful is macular hole surgery?

The most important factor in predicting whether the hole closes as a result of surgery is the length of time the hole has been present. If you've had a holefor less than six months, there's about a90

Can I develop a macular hole in my other eye?

After carefully examining your other eye, your surgeon should be able to tell youthe risk of developing a macular hole in this eye. In some people this is extremely unlikely, in othersthere's a1 in 1

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