Macular holes often begin gradually and affect central vision depending on the severity and extent of the problem. Partial holes only affect part of the macular layers, causing wavy, distorted, blurred vision. Patients with full-thickness macular holes experience a complete loss of central vision.

Signs and Symptoms

The severity of the symptoms is dependent on whether the hole is partial or full-thickness. Common symptoms are blurred central vision, distorted or "wavy" vision, gray area in central vision and blind spot at center.

Detection and Diagnosis

Visual acuity testing, Amsler grid, and ophthalmoscopy are all performed to evaluate the macula's health and function. The retina doctor may also order photographs of the macula prior to performing surgery to repair the hole.

Treatment

Some macular holes seal spontaneously and require no treatment. In many cases, surgery is necessary to close the hole and restore useful vision.

Macular holes are repaired with surgery. During the operation, the surgeon first gently removes the vitreous gel with a procedure called vitrectomy. This eliminates any traction on the macula. A gas bubble is injected in the eye to place gentle pressure on the macula and help the hole to seal. In many cases, patients enjoy functional vision after the bubble has dissipated and the eye has healed.