A macular hole is a defect in the central retina (the macula). Patients who develop a macular hole complain of distorted vision and loss of central vision in the affected eye.

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What causes a macular hole?

The vitreous is the gel that fills the eye and naturally releases/detaches from the retina with age. The majority of macular holes are caused by abnormal traction forces from the vitreous which may pull open a defect in the macula creating a macular hole. Less common causes of a macular hole include blunt trauma to the eye, contraction of a pre-existing epiretinal membrane (macular pucker), or extreme near-sightedness (high myopia).​

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Different Types of Macular Holes

Lamellar macular holes are partial thickness defects. Lamellar holes can cause distortion and decreased vision but generally do not require to surgery.

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Treatment of a macular hole

​Most macular holes are treated with a type of retinal surgery called macular hole repair.  Macular hole repair is a type of vitrectomy, in which the gel inside the eye is removed.  A superficial retinal layer is often removed to facilitate hole closure, and a gas bubble is placed inside the eye.

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Flying or altitude are prohibited until the gas bubble has been absorbed. Macular hole repair is an outpatient procedure that usually takes less than an hour. Surgery is most often performed under local anesthesia, but can be done under general anesthesia as well..  Visual improvement after macular hole repair is gradual, since the return of retinal function requires significant healing time after hole closure.