Macular Holes: Diagnosis and Treatment
How macular holes develop and what treatments restore central vision.
How macular holes form
Macular holes develop when traction from the vitreous pulls on the macula and creates a full-thickness defect. This can cause central blur, distortion, or a dark spot in the center of vision.
Risk factors include age (most common after 60), female sex, high myopia, eye trauma, and certain retinal conditions. The other eye has a modest risk of developing a macular hole over time.
Diagnosis
Optical coherence tomography (OCT) confirms the hole size and stage. A dilated eye exam evaluates the macula and surrounding retina and helps determine the best treatment plan.
Treatment
Vitrectomy with internal limiting membrane peel and gas bubble placement is the standard surgical approach. Postoperative positioning may be required to support closure. Air travel and nitrous oxide anesthesia are restricted while a gas bubble is present.
Image Credit
- OCT of small macular hole on the left eye (CC BY-SA 3.0)
