Macular Hole – Vitrectomy

A macular hole is a break in the retina located in the sharpest part of your vision.  This area is called the macula. A macular hole can be formed from trauma, high nearsightedness, diabetes, macular pucker, Best’s disease, or most commonly, age.

Most of the eye is filled with a gel-like substance called vitreous. As we grow older, the vitreous shrinks and releases from the retinal surface. This is a normal aging change. In some cases, however, it is attached so strongly that it will pull and tear the retina which can create a retinal tear or detachment. If this missing piece of retina is in the macula, it’s called a macular hole. Vision can become blurry, distorted, or a dark spot can appear in the central vision. The degree to which vision is affected will depend on the size and location of the hole, as well as the stage of the macular hole.  

  • Foveal detachment (stage I) – without treatment, about half of Stage I holes will progress 
  • Partial-thickness holes (Stage II) – about 70% worsen without treatment 
  • Full thickness holes (Stage III) – most worsen without treatment 

Vitrectomy surgery is the most common treatment for a macular hole. During the surgery, the doctor uses tiny instruments to remove the vitreous and place a gas bubble inside the eye. This bubble will press against the macula holding it in place while the hole closes. An important part of recovery is strict face down positioning for approximately one week after surgery. Afterwards, the bubble slowly dissolves on its own. Vision should progressively improve over the three to six-month healing time after surgery. The level of vision recovered will depend on many factors including, but not limited to, the size of the hole and how long the hole was present before surgery. At Retina Specialists of Michigan, the doctor and patient together will discuss all the options and collectively decide which treatment would be most beneficial. If you have questions regarding your vision or symptoms, speak with one of our staff at (616) 954-2020.