Macular Hole

For more information, see videos below.

The macula is the center part of the vision. It dictates the fine details of your vision. A normal macula anatomy is essential for good vision. As we age the gel in the back of the eye (vitreous) begins to separate from the retina. As it does so it can have abnormally strong connections with the macula. If these connections are strong enough they can cause traction at the macula or a macula hole to form.

Signs and Symptoms

  • Blurred central vision
  • Distorted, “wavy” vision
  • Decreased detail vision
  • Gray area in central vision
  • Central blind spot

Detection and Diagnosis

Visual acuity testing, Amsler grid, and ophthalmoscopy are all performed to evaluate the macula. Fluorescein angiography and Optical Coherence Tomography are also performed to assess the macular hole.


Treatment of a macula issue begins with staging it. Early macular holes or traction at the macula without a hole can be treated in the office with a gas bubble and positioning. When macular holes progress Vitrectomy is the most common procedure chosen to address the problem. This involves an outpatient procedure in the operating room where the gel (vitreous) is removed and replaced with a gas bubble. Relieving the gel relieves the traction allowing the hole to close and the vision to improve.
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Macular Hole Surgery

For more information on macular hole surgery, view this video.