A break or hole in the macula usually affects those aged 60 and over. It can cause blurred and distorted central vision.
The macula is the tiny, central area of your retina (the focusing surface at the back of your eye). It allows you to see things directly in front of you and lets you see colour and detail. A hole in the macula can cause blurring, blank spots and distortion of your central vision.
The symptoms of a macular hole are quite similar to those of macular degeneration. It is also most common in people aged 50 to 70. However, the conditions are quite different, and you should see an eye specialist if you suspect either.
A macular hole generally only affects your central vision, so your peripheral or ‘side’ vision will remain unaffected. You may have difficulty with reading and close work, and you may notice grey or black spots, or blank areas, in your vision. Macular holes usually affect one eye rather than both. However, both eyes can be affected by macular holes.
Macular holes usually develop over time, so you may not notice any symptoms until your vision is affected. Early signs include blurring and distortion of your vision. You may notice straight lines (such as window frames, telegraph poles or lines of text) appearing bent or wavy.
The Amsler Grid is a simple test that will help you determine if your vision is distorted in this way.
An Amsler Grid with straight lines as seen by a normal-sighted person
A person with macular problems may notice distortion of the grid pattern, such as bent lines, irregular box shapes or a grey shaded area.
The size and location of the macular hole will determine how much it affects your vision. There are also three stages of macular hole, and vision will generally deteriorate as the condition worsens.
As we age, the vitreous ‘gel’ inside the eye naturally shrinks and pulls away from the retina. Occasionally, the vitreous gel can pull on the retina and create a macular hole. In some cases, the fluid that fills the gap left by the vitreous gel may seep through the hole onto the macula, causing blurring and distortion.
Other conditions that increase risk
The presence of another eye condition may increase your chances of developing a macular hole. These include:
Treatment is most effective when carried out early in the development of the condition. An operation called a vitrectomy can carefully remove the vitreous ‘gel’ from the affected eye and replace it with a gas that helps the macula heal.
Some macular holes can self resolve, but most require treatment to prevent vision loss. It is best to have an assessment with an eye care professional to follow their advice and preserve your vision.
Is there anything I can do to prevent or improve a macular hole
There is nothing you can do to prevent or improve a macular hole as the vast majority occur spontaneously without any obvious cause. Having your eyes assessed routinely is the best way for early detection and treatment of a macular hole should it develop.
Is there pain or discomfort associated with the development of a macular hole?
There are no physical sensations associated with the development of a macular hole. The only symptoms will be a gradual decline in central vision associated with blurriness, distortion or a dark spot obstructing vision.
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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. Macular holes are related to aging and usually occur in people over age 60. Click here to read more.
Macular hole is when a tear or opening forms in your macula. As the hole forms, things in your central vision will look blurry, wavy or distorted. As the hole grows, a dark or blind spot appears in your central vision. A macular hole does not affect your peripheral (side) vision.
What Causes a Macular Hole?
Age is the most common cause of macular hole. As you get older, the vitreous begins to shrink and pull away from the retina. Usually the vitreous pulls away with no problems. But sometimes the vitreous can stick to the retina. This causes the macula to stretch and a hole to form.
Sometimes a macular hole can form when the macula swells from other eye disease. Or it can be caused by an eye injury. Click here to read more.
A vitrectomy is the most common treatment for macular holes. In this surgery, a retinal specialist removes the vitreous gel to stop it from pulling on the retina. Then the specialist inserts a mixture of air and gas into the space once occupied by the vitreous.