Macular Holes

The macula is a small spot in the center of your retina. It is filled with light sensitive cells called cones that are responsible for color vision and the recognition of objects such as faces. The rest of your retina contains photosensitive cells called rods. Rods are responsible for black and white shading, and shape and movement detected by side vision. When a hole develops in your macula, your ability to see objects straight-on can become quickly impacted.

Like macular degeneration, macular holes are an age-related disorder and more common in people over the age of 60. Unlike macular degeneration, macular holes are not related to lifestyle choices or genetics and can be caused by things such as:

Diabetes
Eye injury
Detached retina
Macular pucker
Severe cases of myopia

The most common cause of macular holes is vitreous shrinkage or separation.

Vitreous Shrinkage and Separation

Your vitreous is attached to your retina. As you age, your vitreous can change from a gel-like substance into a pure liquid. This results in shrinkage of your vitreous. As your vitreous shrinks, it can pull on your retina, tearing off small pieces and causing a hole in your macula.

Likewise, this shrinking can cause the strands of cells that attach your vitreous humor to your retina to break away from the vitreous. When this happens, the strands attached to your retina can cause traction that leads to holes in the macula.

In both instances, fluid will develop in the space where the vitreous has shrunk and seep into your macula causing blurred vision. Left untreated, your vision can worsen over time, eventually resulting in permanent vision loss.

Macular Hole Treatment

The most common treatment for macular holes is a vitrectomy. In this procedure, your ophthalmologist will remove the gel from your vitreous humor and replace it with a combination of air and gas that will put pressure on your macula and cause the hole to heal. In time, the air and gas will be replaced by your natural eye fluids and vision will be restored.

This common surgery is not without its drawbacks. While the bubble placed by your ophthalmologist is providing pressure, it must be kept in place. To keep it in place, you are required to lie face down until your eye’s natural fluids fill the space. This process has been known to take up to three weeks. While this may seem like an inordinately long amount of time, it is the only way to ensure you do not lose your vision, making it rather inconsequential in the long run.

If you are experiencing decreased vision for any reason, please contact an experienced ophthalmologist in your area to schedule an initial consultation today.