Retinal Conditions

Macular Hole

The macula is a vital part of the eye responsible for clear detailed vision. It is located in the center of the retina’s light sensitive tissue.

A macular hole is a small break in the macula, which disrupts central, forward-facing vision. The size and location of the hole will determine how much of a person’s vision will be affected. If left untreated, a macular hole will slowly grow in size.

Most of the eye’s interior is filled with vitreous, a gel-like substance that helps maintain its round shape. The vitreous contains millions of fine fibres, which are attached to the surface of the retina. As part of the natural aging process the vitreous shrinks and begins to separate from the retina, pulling at the retinal surface. This is normal and usually causes minimal adverse effects.

some, they may experience floaters or specks of dust that seem to float throughout their field of vision. However, if the vitreous is firmly attached to the retina, over time the constant tension on the retinal tissue will give way, tearing the macula and creating a macular hole.

Symptoms of Macular Holes

Macular holes tend to begin gradually. In the early stages once a macular hole has formed, patients will begin to notice a slight distortion or blurriness in their straight-ahead, central field of vision.

As the macular hole progresses, a blind spot will develop in the central field of vision (straight ahead), impairing the ability to see at both distant and close range. Routine tasks such using a computer, driving, or even simply reading a book will become difficult as this blind spot in the affected eye grows and becomes darker.

Worse still, after a macular hole develops in one eye, there is a 10-15% chance of a macular hole forming in the other eye. In this case, even simple activities requiring forward-facing vision will become a challenge as the blind spot increases in severity.

Causes of Macular Holes

Patients that are at higher risk of developing macular holes include the following conditions:

  • Part of the natural aging process, particularly for those over the age of 60 years old (more frequently for woman)
  • Severe nearsightedness / myopia in one or both eyes
  • Past eye injuries
  • Previous retinal detachment or retinal tear
  • Diabetes
  • Severe or long-term inflammation in the eye, such as uveitis

Diagnosing Macular Holes

Macular holes can be identified during clinical eye exam and by an optical coherence tomography (OCT) exam. This test can be performed by your retinal specialist and is safe and painless.

Treatment of Macular Holes

Macular holes require prompt treatment from a retinal specialist in order to safeguard vision and prevent more serious eye conditions from forming. Treatment of macular holes is performed with an injection of Jetrea or by a vitrectomy procedure. This is the most effective treatment to repair a macular hole and prevent further vision loss.

You can read a detailed description of this corrective procedure by clicking this link to learn about a vitrectomy.

Following your initial assessment and diagnosis, your retinal specialist will determine how quickly treatment needs to be performed. The sooner treatment is carried out, the better the outcome for your vision, which is why it is important to schedule regular eye exams with your eye care professional.