A macular hole is a full-thickness defect in the central retina at the macula. It typically causes distortion and a central blind spot in one eye.
Causes and symptoms
Most macular holes relate to age-related changes and traction from the vitreous.
- Blurred central vision and difficulty reading or recognising faces
- Straight lines appearing bent or broken
- Often gradual onset in one eye, with the other eye compensating
- OCT imaging confirms the size and stage of the hole
Treatment
Vitrectomy surgery with internal limiting membrane peel is the main treatment.
- Gas bubble placement helps the hole edges come together
- Face-down or specific positioning may be recommended post-operatively
- High closure rates with potential for meaningful visual improvement
- Fellow eye monitoring because risk of a second hole is slightly increased
