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Why Do Macular Holes Occur?

By admin | Jul 19, 2016

What is the Macula?

The back of your eye is a sensitive network of neural tissue and light-sensitive cells which allows you to perceive light and shapes.  These light sensitive cells called rods and cones specifically deal with seeing colors, black and white shading, shapes and movement. The macula is a light sensitive area in the middle of the retina and is responsible for sharp central vision.  When light is properly focused on the macula, it is transmitted to the brain, resulting in clear vision.  This is especially important for driving and recognizing faces.

How Do Macular Holes Occur?

Most macular holes occur due to vitreomacular traction.  This is caused by the vitreous gel pulling away from the retina, tugging the macula with it.  People over the age of 60 are at higher risk.  Macular holes can also be the result of trauma, or can occur in patients with high myopia (nearsightedness), or macular puckers.  Patients often will notice macular hole symptoms as an immediate decrease in their vision in one eye compared to the other. Specifically, vision will become blurred and distorted in the central visual field.

Diagnosis and Treatment

There are different stages to a macular hole:

  • Foveal detachments (Stage I).
  • Partial-thickness holes (Stage II).
  • Full-thickness holes (Stage III). (Source:

The prognosis and treatment approach to your macular hole depends on several factors (such as which stage your macular hole has progressed to), details of which you and your retina specialist will discuss.  Using the state of the art testing and diagnostic techniques at our offices, our retina specialists will diagnose a macular hole and work with you to develop a macular hole treatment plan with the best possible outcomes for your vision in mind.

Treatment Options

In the early stages, it is likely that your retina specialist will monitor your condition closely and have you return for an appointment immediately, should your vision decrease any further. If your vision worsens and the hole continues to progress, your retina specialist will use macular hole surgery to repair it.  This is called a vitrectomy surgery and is an outpatient procedure. This procedure may require you to have gas or oil administered in the surgical eye to push the macular hole closed.  Your retina specialists will thoroughly discuss the specifics of your treatment plan and prognosis with you during your visit.

As always, if you experience any sudden changes to your vision, it is of the utmost importance to schedule an appointment with your ophthalmologist or retina specialist right away. This ensures your doctor can address your eye problem in a timely manner and achieve the best possible prognosis for your vision. At Retina Consultants of Boston, your eye health is our top priority!

In the interest of maintaining further transparency and providing a wide breadth of information to our patients and providers, this blog will serve as an educational and informative resource on interesting happenings within Retina Consultants of Boston and in the greater field of Ophthalmology.

Here at Retina Consultants of Boston, Dr. John J. Weiter and Dr. Namrata Nandakumar are on the forefront of diagnostic techniques, treatment and micro-surgical techniques for macular degeneration, diabetic retinopathy, retinal detachments, macular holes, and a number of other issues affecting the vitreous and retina. Check back here frequently for news and updates on our practice and all things retina!