The macula is the tiny, central area of your retina (the focusing surface at the back of your eye). It allows you to see things directly in front of you, and also lets you see colour and detail.
A hole in the macula can cause blurring, blank spots and distortion of your central vision.
As we age, the vitreous inside the eye can shrink and pull on the retina, creating a hole in the macula. In its early stages, a macular hole can cause a slight distortion or blurriness in the central vision. Reading, and performing other routine tasks, such as driving, may become difficult.
If the condition progresses, patients will experience a loss of central vision. If left untreated, the vision loss from the macular hole can be permanent.
Macular hole symptoms
Macular holes usually develop over time, so you may not notice any symptoms until your vision is affected. Early signs include blurring and distortion of your vision, and you may notice straight lines (such as window frames or lines of text) appearing bent or wavy.
A macular hole generally only affects your central vision, so your peripheral vision will remain unaffected. You may have difficulty with reading and close work, and you may notice grey/black spots or blank areas in your vision. Macular holes usually affect one eye rather than both; although it is possible for both eyes to be affected by macular holes.
The symptoms of a macular hole are quite similar to those of macular degeneration. Like macular degeneration it is also most common in people aged 60 and over. However, the conditions are quite different and you should see an eye specialist if you suspect either.
The size and location of the macular hole will determine how much it affects your vision. There are also three stages of macular hole and vision will generally deteriorate as the condition worsens.
Causes of macular holes
As we age, the vitreous ‘gel’ inside the eye naturally shrinks and pulls away from the retina. Occasionally, the vitreous gel can pull on the retina and create a macular hole. In some cases, the fluid that fills the gap left by the vitreous gel may seep through the hole onto the macula, causing blurring and distortion.
The presence of another eye condition may also increase your chances of developing a macular hole. These include:
- Diabetic retinopathy
- Epiretinal membranes
- Eye injury or trauma
- Retinal detachment
- Severe short-sightedness
Treatment for a macular hole
Macular hole treatment is generally most effective when carried out early in the development of the condition. An operation called a vitrectomy is used to carefully remove the vitreous ‘gel’ from the affected eye and replace it with a gas that helps the macula heal.