Stages of Macular Holes

A macular hole is a condition where a full-thickness hole develops in the central retina or macula. A small break develops in the macula, located in the center of the eye’s light-sensitive tissue. The macula provides the sharp, central vision we need for reading, driving and seeing fine detail.

Macular holes can cause blurred and distorted vision. Macular holes are related to aging and often occur in people over the age of 60.

There are four stages of macular hole development: 

• Stage 1 is foveal detachments. Without treatment, about half of Stage I macular holes will progress.

• Stage 2 is partial-thickness holes. Without treatment, about 70 percent of Stage II macular holes will progress.
• Stage 3 is when a full-thickness hole exists. It is greater than 400 µm in size and is still attached with partial vitreomacular adhesion/traction
• Stage 4 is when a full-thickness macular hole exists in the presence of a complete separation of the vitreous from the macula and the optic disc.

The size of the hole and its location on the retina determine how much it will affect vision. Central and detailed vision is often lost when a stage 3 macular hole develops.  If left untreated, a macular hole can lead to a detached retina, a sight-threatening condition that requires immediate medical attention.

At your evaluation, your doctor will perform a dilated exam using a slit lamp to determine the extent of the hole and its effect on the macula. To check the outer retina, the doctor will use an indirect ophthalmoscope. To confirm the presence of a hole or to determine the stage it is in, the doctor may order several tests.  To find out more or to schedule an evaluation, please contact Associated Retina Consultants in Phoenix at 602-242-4928 or associatedretinaconsultants.com.