Macular Hole

What is a macular hole? The retina is the thin layer of nerve tissue lining the back of the eye that detects light and sends information to the brain to allow us to see. The macula is the central area of the retina and is used for seeing fine detail and reading. Sometimes, a hole forms in the macula, which affects your vision, particularly when reading and performing other visually demanding tasks, but it does not cause total blindness.

Treatment of macular hole

The only consistently successful way to treat a macular hole (Figure 1) is an operation. Eye drops or glasses are ineffective. An alternative to surgery is a new therapy called ocriplasmin which is a drug injected into the eye. Although an initial study has shown that this treatment may be beneficial in selected cases, it is still undergoing clinical assessment. Generally, it is not as reliable as surgery and the majority of patients treated with ocriplasmin will go on to have surgery. This option can be discussed with your consultant.

Risks of surgery

The success rate of macular hole surgery – a vitrectomy – depends on many factors, and you should discuss these with your eye doctor. Overall, there is about a 90% chance of “closing” the macular hole. Nevertheless, there is a small chance that your vision may not improve after surgery, even if the hole is “closed”.

Surgery for macular hole repairs is generally very safe.