What is the macular hole?
A macular hole is a tear that occurs in the macula or centre of the retina. This area at the back of the eye (which is no more than 3 millimetres in diameter) is responsible for detailed vision, which provides us with the finest visual acuity and allows us to read, sew, recognise faces and perform many other precise everyday tasks.
A macular hole usually occurs due to the traction of the vitreous gel that fills the eyeball on the retina (the innermost layer of the eye) to which it is attached, breaking it and causing an opening in its most fragile and thinnest part: the macula.
A macular hole can be very subtle at first and go unnoticed, although, if it grows, it can end up severely affecting central vision, even causing a blind spot or stain in the centre of vision.
Although in some patients a macular hole can occur in both eyes, it usually affects only one eye. Thus, covering one eye first and then the other to compare your vision in each case (if you see more blurry, if straight lines seem crooked or wavy …), can help you detect this disease, as well as having regular check-ups with your ophthalmologist.
In many cases, this pathology is related to the ageing of the eye; thus, it is more common in people over 60. The reason is that, with age, the vitreous gel contracts and shrinks, distancing itself from the retina. It is usually a process that does not cause damage to the retinal tissue, although, sometimes, it can cause a macular hole, if the vitreous remains attached to the retina, pulling and deforming it, eventually breaking it.
Apart from age, there are other factors that can also explain a macular hole, related to different ocular causes, such as:
- High myopia
- Retinal detachment
- Macular oedema
- Macular epiretinal membrane
- Eye trauma
- Eye inflammations
- Certain former surgeries
To diagnose key diseases in time in order to treat them early and improve the chances of visual recovery, which, in fact, are over 95%, if we operate on the macular hole within the first 6 months after it forms.
At the Miranza eye centres, we boast leading specialists in macular hole surgery and in the management of complex cases (such as high myopic patients). Furthermore, although the treatment of this disease is generally surgical (usually, vitrectomy), we are also committed to innovation and the safe application of new therapeutic alternatives, such as ocriplasmin. This drug is injected into the eye to treat vitreomacular traction that could lead to a hole, as well as small holes.