What is Macular Hole: Causes, Symptoms and Treatment

Sparkling Eyes

When your grandparents read every morning, do you see them holding their newspaper at an apparent distance from their body? They also squint their eyes as they read the newspaper. This condition is expected as some eye irregularities are rampant, especially when a person ages and reaches 45 and above. This condition is Macular Hole. 

What is Macula?

The macula is an area located at the center of the retina. It has yellow pigment, making it a natural sunscreen that guards this part of the eye from damage. It is also a space where the cone cells are located. This helps us appreciate details in our vision, mainly when watching, reading and looking at specific objects. 

Macular Hole

A macular hole is when an opening or a tear forms in your macula. As the hole forms, things in your center vision will look wavy, blurry, or distorted. As the hole grows, a blind or dark spot appears in your central vision. A macular hole does not affect your peripheral (side) vision.


Age is the most probable cause of the macular hole. As you age, the vitreous begins to contract and pull away from the retina. Usually, the vitreous pulls out with no problems. But sometimes it can stick to the retina. This makes the macula to stretch and causes a hole to form. Sometimes a macular hole can develop when the macula swells from another eye disease. Or it can be caused by an eye injury. It is also caused by diabetic eye disease, high degree of myopia, and Macular pucker. 

Symptoms of Macula Hole

The symptoms of a macular hole include:

  • A reduction in the capacity to see fine details when a person is looking straight at an object, no matter how far away or close it is.
  • A shift in vision that makes a person feel like he or she is looking through dense, thick or fog, wavy glass.
  • The presence of a dark spot across the middle of the field of view is a typically visible symptom. 
  • Symptoms also include itching in the eyes, headache and nausea when staring at something for a longer duration. 


The first step in Macular Holes treatment involves diagnosis testing. Optical coherence tomography (OCT) is the modern gold standard in staging, diagnosing, and managing macular holes. In most cases, surgery is not needed. It is worthwhile waiting a short time to see if a small macular hole will close on its own. When macular holes abort or automatically close, the vision often returns to normal over about a year. However, if a surgical procedure is recommended, the results are quick. 

Vitrectomy is the most popular surgical solution for macular holes. In this operational method, the vitreous gel is eliminated to stop it from dragging on the retina. A gas bubble is most commonly fixed in the eye to smoothly hold the edges of the macular hole closed until it repairs, recovers, and heals. Vitrectomy has a success rate of over 90%, with cases regaining some or most lost vision. The procedure’s potential complications include retinal detachment, infection, cataract formation, bleeding, glaucoma, and persistence or re-opening of the macular hole.

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