Macular Holes

The macula is the part of your eye responsible for your central (reading) vision. When a hole develops in your macula, you cannot read or see clearly. You may even experience significant vision loss. If you develop this condition, you will not feel any pain.

What Causes Macular Holes?

As you age, the vitreous, a jelly-like substance in your eye, shrinks and pulls away from your retina. The retina is located at the back of your eye. Sometimes, the pull is so strong, it causes a hole on your macula. When this happens, fluid seeps through the hole onto the macula, which blurs and distorts your central vision.

Other causes of this condition include:

• High myopia (near-sightedness)
• Eye injury
• Retinal detachment
• Macular pucker

Saving Your Sight

Macular holes can lead to significant loss of eyesight. The best way to protect yourself from this condition is through regular eye exams so your doctor can detect them early or prevent holes from forming. If you experience blurred or distorted vision, don’t wait. Contact Bascom Palmer Eye Institute, part of the University of Miami Health System, right away.

If you have a hole, your retinal specialist will find them during your exam. You and your specialist will discuss treatment options based on your age, the severity of your condition, and your tolerance for certain medications and procedures. Together, you decide on a treatment plan. Using expertise and advanced technology, our ophthalmologists achieve their main goal – restoring your vision as quickly as possible.

If your eyesight is threatened, expert care from a trusted leader is your fastest, safest path to saving your sight.

Tests

Visual Acuity Test – In this test, your eye technician measures how well you see at a distance.

Dilated Pupil Exam – The technician places dilating drops in your eyes, allows your pupils to dilate or enlarge. Using an ophthalmoscope’s bright light and special lens, your physician then examines the inside of your eye.

Optical Coherence Tomography (OCT) – OCT is an imaging method that provides cross-sectional, three-dimensional (3-D) views of the inside of your eye.

Fluorescein Angiography – To perform this test, your physician injects a fluorescent yellow dye into a vein in your arm or hand, then takes pictures of the inside of your eye as the dye outlines your blood vessels.

Treatments

Surgery – While not every patient with macular damage needs surgery, it is successful for many. To surgically repair a hole, the retinal surgeon removes the eye’s natural vitreous, a gel-like substance, and injects gas inside the eye. This gas bubble acts as an internal, temporary bandage. As the hole heals, the bubble holds the edge of the hole in place. To aid your healing, you must usually remain in a face down position for one week after surgery. This allows the bubble to press against the macula and properly seal the hole. Over two to six weeks, the bubble gradually reabsorbs as the vitreous area refills with a naturally produced fluid.