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Macular Hole Causes Symptoms and treatment

Macular hole

Doughnuts, Volcanoes, Swiss cheese, Golf Courses, Our Roads…. Some things are unimaginable without holes. But who would think that you could have one in your eye too?

What is the macula?

The macula is a small area in the centre of your retina (the light sensitive screen at the back of your eye). It consists of cells called cones that are responsible for sharp vision and perceiving colour.

What is a macular hole?

A macular hole is a defect in the retina which involves its full thickness. It is also called as a macular cyst or retinal perforation or retinal hole.



What causes a Macular Hole?

If you are above the age of 60 and are a woman, you are more likely to develop macular holes.


Macular Holes can occur because of the following causes:

Vitreous shrinking : As you age, the thick jelly like substance inside your eye called the vitreous begins to shrink and pull away from the macula. Usually, this does not have much of an effect on your sight. But if this vitreous gets stuck to the macula and can’t pull away, then the macular tissue gets stretched and ultimately develops a tear called a macular hole.


High Blood pressure

Severe Nearsightedness

Macular pucker (a scar tissue on the macula)

Less than 10 % of people who develop a macular hole have a history of an eye injury.


Do I have a Macular Hole? (Signs and Symptoms)

Symptoms are usually seen to appear gradually over a few days or weeks. In the early stages, your symptoms may not be very obvious to you. Symptoms are usually seen in one eye only.

Your central vision begins to blur and distort. Your ability to see fine details might decrease. As your macular hole progresses, you may develop a blind spot in your central vision.  This impairs your distant as well as close vision.



What are the tests for Macular Holes?

Ocular Coherence Tomography (OCT): This helps your doctor to see a cross sectional image of your retina.



Fluorescein Angiography: In this test a dye is used to illuminate areas of your retina.

How is a Macular Hole treated?

If you have been identified with a macular hole that is in the first stage, there is a 50% chance of your hole resolving spontaneously. On the other hand, if it has reached stage 2, then you would most likely require surgery.

Vitrectomy surgery is done in which the gel that is tugging on your macula is removed. Your eye is then replaced with an oil or a special gas bubble. This bubble flattens out your macula and holds it in place until the hole can heal.



That is why you would be required to maintain a specific face down position after your surgery. This may range from a few days to a few weeks, depending on your doctor’s recommendation. The bubble either dissolves on its own or may be removed by your doctor. If a gas bubble has been used, you will not be allowed to fly by plane as the increase in altitude can cause an increase in your eye pressure as long as you have the bubble in your eye.

If you have had a macular hole in one eye, you have a 10% higher chance of developing one in your other eye sometime later.That is why regular eye check ups are very important.