What is a macular hole?
A macular hole is a small break in the macula. Whereas a similar sized hole elsewhere in the retina may not be noticed (unless the hole progressed to retinal detachment), a hole in the very center of the macula is extremely noticeable, because the center of the macula is where light is sharply focused to produce the detailed color vision used for detailed tasks such as reading and driving. The most common symptom of a macular hole is a gradual decline in the central vision, and may be noticed as blurring, distortion (straight lines appearing wavy), or a dark spot in the central vision.
What is the treatment for a macular hole?
Macular holes almost always occur in association with epiretinal membranes, and therefore, vitrectomy with peeling of epiretinal membranes (and also internal limiting membranes) circumferential to the hole allows release of circumferential traction which allows increased tissue mobility and hole closure. In addition to vitrectomy with membrane peeling, your retinal surgeon will leave the back of the eye filled with an air or gas bubble, and may suggest certain head positioning for a period of time (a few days to a week) to facilitate closure of the macular hole. While complete recovery to 20/20 vision and complete resolution of central distortion is rarely seen, macular hole surgery has a success rate of over 90%, with patients regaining some or most of their lost vision.