Everything you need to know about Macular Hole

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Macula is the center of the retina, a small area where light is sharply focused, producing a detailed color vision. A macular hole is a small break in the macula. The macula is responsible for producing sharp, central vision needed for activities involving seeing fine details like reading. The macular hole thus, causes a blurred and distorted central vision commonly occurring in people over 60 years of age. Macular Hole surgery in India is a successful treatment depending on the size of the hole and its location on the retina. If left untreated, it can lead to a detached retina.

There are in total three different stages to a macular hole:

  1. Stage 1 – Stage 1 is about Foveal detachments wherein if there’s an absence of treatment, almost half of macular holes will progress.
  2. Stage 2 – This is about partial thickness holes in which case over 70% of stage 2 macular holes will progress without treatment.
  3. Stage 3 – This is the final stage with full thickness holes.

The overall hole size and the location on the retina is used to determine the extent of the effect this condition will have on the patient’s vision. In case of the Stage 3 macular hole, central vision can be completely lost. Hence, treatment at an early stage becomes the need of the hour in such cases.

One important thing to note here is that if a macular hole exists in one eye, there is a 10-15% chance that it will develop in the other eye as well over the course of a lifetime. It might not be an urgent situation; however, discussing this with your doctor is a smart option.


  • Vitreous traction- the gel that fills 80% of the eye shrinks and pulls away from retina as aging progresses that tears the retina creating a macular hole.
  • Injury or trauma – this is one of the most common causes when it comes to the case of a macular hole
  • High Degree of myopia (shortsightedness)
  • Diabetes


The symptoms develop gradually; however, an individual should book a doctor’s appointment immediately if any of the following symptoms persists.

  • Blurred and distorted vision (straight lines appearing wavy)
  • Difficulty in reading
  • Headache on concentrating
  • Dark spots in the central vision


Optical Coherence Tomography (OCT) is used to diagnose and identify the stage of macular holes. This technique involves imaging in high resolution using reflected light. Laboratory tests are not required for the idiopathic macular holes which are formed without a known cause.


The most common Macular Hole treatment in India is vitrectomy. It is a surgical process in which the vitreous gel is removed and a gas bubble is placed in the eye. The patient is asked to stay in a face-down position for several days (up to 2 weeks) depending upon the size and location of macular hole. This lets the bubble to dissolve and replaced by natural eye fluids. The treatment has over 90% success rate. Some patients are also treated by the use of injection ocriplasmin into the vitreous.

However, in many cases where the macular hole is very small and doesn’t affect the vision, natural healing can help in complete recovery. The recovery term depends from patient to patient and can’t be predicted.