Are Macular Holes Serious?

A macular hole is a small break in the macula, located in the center of the eye’s light-sensitive tissue called the retina. The macula provides the sharp, central vision we need for reading, driving and seeing fine detail. A macular hole can cause blurred and distorted central vision.

Most of the eye’s interior is filled with vitreous, a gel-like substance that fills about 80% of the eye and helps it maintain a round shape. The vitreous contains millions of fine fibers that are attached to the surface of the retina. As we age, the vitreous slowly shrinks and pulls away from the retinal surface. Natural fluids fill the area where the vitreous has contracted. This is normal, and in most cases, there are no adverse effects. Some patients may experience a small increase in floaters which are little “cobwebs” or specks that seem to float about in your field of vision.

However, if the vitreous is firmly attached to the retina when it pulls away, it can tear the retina and create a macular hole. Also, once the vitreous has pulled away from the surface of the retina, some of the fibers can remain on the retinal surface and can contract. This increases tension on the retina and can lead to a macular hole. In either case, the fluid that has replaced the shrunken vitreous can then seep through the hole onto the macula, blurring and distorting central vision.

Macular holes are associated with aging and usually occur in people over the age of 60. Several conditions can increase the risk of macular hole formation including:

Injury or trauma: some young people develop macular holes after blunt trauma
Diabetic eye disease
High degree of myopia (nearsightedness)
Macular pucker: formation of a scar tissue layer over the macula that can warp and contract, causing wrinkling of the retina
Retinal detachment

If you would like more information about macular holes and their causes, please contact Associated Retina Consultants at 602-242-4928 or website to schedule an appointment with our doctors.