Macular Hole

A macular hole is a defect in the macula, which is the center of the retina that provides focused vision. It occurs more frequently as we age, when the vitreous gel within the white portion of the eye begins to shrink. Sometimes the shrinkage pulls on the macula and causes a defect. A macular hole is a serious condition because it can lead to a loss of vision.

Virginia Mason ophthalmologists have broad experience diagnosing and treating patients with retinal disorders, including macular hole. For more information about macular holes, or to schedule an appointment with a Virginia Mason ophthalmologist, call (206) 223-6840.

Symptoms of a Macular Hole

Blurry, wavy or distorted vision are the most common signs of a macular hole. These signs result when a defect develops in the center of the macula, causing vision problems.

Diagnosing a Macular Hole

Your eye doctor will first have you undergo a visual acuity test to examine your distance vision. Your eyes will then be dilated so that he or she can examine the internal structure of your eyes, including the retina. If a macular hole is suspected, you may have additional imaging studies of the retina performed.

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Treating Patients with a Macular Hole

In some cases, the macular hole will heal itself, but this does not normally occur. In most cases surgery is recommended to remove the vitreous gel (vitrectomy) so that it no longer pulls on the retina. During surgery, your ophthalmologist will replace the vitreous gel with an air or gas bubble that acts to hold the retina in place during healing.

Following surgery, at home, you may be asked to lie in a prone position, keeping your head still and facing downward. Keeping your head in this position may help the healing process. You also will use prescription eyedrops and be asked to wear an eye patch for one or more days. You will be scheduled for follow-up visits for several weeks after the surgery.

  • Important Information: You will be instructed not to fly in an airplane or travel to high altitudes until your ophthalmologist determines that the gas bubble is gone. Flying or traveling to high altitudes can cause pressure build-up within the eye and permanent loss of vision.

The majority of patients — 60 percent to 90 percent — treated for a macular hole have a successful outcome, with the hole closing and vision retained or improved. Your ophthalmologist will talk with you about the amount of vision you can expect following treatment.

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