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Macular Hole - Symptoms, Causes, Treatment & Prevention Of It!

Written and reviewed by
Fellowship in Retina (FMRF)
Ophthalmologist,  •  16years experience
Macular Hole - Symptoms, Causes, Treatment & Prevention Of It!

The macula is a very small spot at the back of the eye responsible for light sensing tissue called retina. The macula is the reason that one can see clearly. Macular Holes can occur on the surface of the macula which results in distorted vision. Macular Holes develop with age, so people around the age of 60 might face Macular Holes in the eye, causing visual disability.

Macular Holes should be treated within time. If left untreated, it can create conditions for blindness. The stages of Macular Hole progression are:

  1. Foveal detachments

  2. Partial thickness holes

  3. Full-thickness holes

Symptoms of Macular Holes:

Macular Holes cause problems with the central vision. So, the side vision will be unaffected by this condition. Macular Holes generally occur in one eye. But, the other eye remains intact if the condition persists. Some of the symptoms of Macular Holes are:

  1. Blurry vision

  2. Distorted vision

  3. Difficulty in recognizing colors

  4. Black and white spots in the center of the eye

Causes of Macular Holes:

Vitreous gel shrinkage or pulling away is one of the main reasons that Macular Holes occur. If the vitreous gel is firmly attached to the retina, it causes a tear in the macula when pulled away from the surface, making a small hole. The gap which is created by the gel is sometimes filled with the seepage formed by the hole. This causes a problem of visual disability. However, the location and size of the hole determine the condition of the patient’s problem.

Macular Holes are not the development of cysts or tear. They are different from Macular Degeneration. Generally, Macular Holes occur due to:

  1. Aging

  2. Detachment of the retina

  3. Diabetes

  4. An eye injury

  5. Myopia disease

  6. Inheritance

Treatment of Macular holes:

In many cases, Macular Holes heal themselves. But if left untreated, it may lead to full blindness. Vitrectomy surgery has been suggested by doctors to treat Macular Holes. In this surgery, surgeons remove the vitreous gel from the eye which are causing tension on the surface of the retina. Space is then filled with gas and bubbles. With the pressure of the gas, the macula region remains sealed and heals itself.

After surgery, the doctor may ask a person to lie down straight with their face upwards so that the bubble in the eye remains in place. Doctors may suggest this for a full 24 hours.


Face down or upward position after surgery is absolutely necessary for the patient as the bubble may cause a problem for the eyes. It is advisable for the patient to talk about the doctor for the same. If one cannot stay his/her face downwards for that long, he/she must discuss the same with doctor before surgery. Also, if a person has had surgery with a gas bubble, he/she may not travel in the air for several months as gas may expand and cause damage to the eyes.

Take Away:

Patients with a Macular Hole in one eye have the chance to develop it in another eye. It is recommended by doctors to get a regular eye and routine follow up. Thus, one should take his/her eyes seriously and get them checked up regularly.

In case you have a concern or query you can always consult a specialist & get answers to your questions!
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