In every individual, there is a gel that occupies the back space of the eye called the vitreous gel. Over time, a natural process occurs where the gel will turn into a liquid and start to pull away from the retina. In some patients, the gel is more adherent to the retina and may not want to let go of the retina completely. This traction can cause the macular tissue to eventually stretch and tear, which leads to the formation of a hole.
Common symptoms include a blind spot in your central vision, a greyish blurred appearance in your central vision, or distortion in vision similar to looking through foggy or wavy glass.
Typically, macular holes form in adults aged 60 years and older.
If a macular hole is very small and is not greatly disturbing your vision, observation can be recommended. In a small percentage of patients, the hole can spontaneously close itself. If the macular hole is large and is causing a lot of visual change, surgery is performed to try and close the hole. As the hold closes, the eye usually regains some lost eyesight. However, the vision is never completely the same, and how much vision is restored depends on the size of the hole and how long it was present before surgery. Early treatment offers the best chance at long term visual success, so do not wait to call us if you are experiencing any visual change!