Macular hole

A macular hole is a small hole in the macula which is in the centre of the retina.

What is macular hole?

Imagine your eye is like a camera. The retina is like the photographic film at the back of the camera. It's a very thin layer of tissue that picks up images and sends them to your brain, allowing us to see.

At the very centre of the retina is the macula. This is a special area we use for seeing fine detail, like when you're reading or recognising faces.

A macular hole is a small hole or tear in the centre of the macula. This stops the macula from working normally. It affects your central vision, particularly for reading and other tasks that need sharp sight.

A macular hole does not cause total blindness. It only affects your central vision. Your side (peripheral) vision will not be affected.

What causes macular hole?

Most macular holes happen as part of the eye's natural ageing process. The jellylike substance that fills the inside of your eye is called the vitreous gel. As we get older, this gel can shrink and pull away from the retina. Sometimes, it pulls too hard on the macula, causing a tiny hole to form.

Macular holes are more common in people over 60 and are twice as likely to affect women. In about 1 in 10 cases, it can affect both eyes.

Less commonly, macular holes can also form after:

  • An eye injury or trauma.
  • Severe short-sightedness (high myopia).
  • Swelling (inflammation) inside the eye.
  • Other eye conditions, such as diabetic eye disease.

What are the symptoms of macular hole?

A macular hole affects the central region of the vision used for reading and recognising other fine detail.

Macular holes often start slowly and the symptoms will depend on the size of the hole. Whilst some people barely notice it at all, others experience:.

  • Slight blurring or fogginess in the centre of your vision.
  • Distorted or wavy vision: Straight lines or letters might look bent or crooked.
  • Difficulty reading: Especially small print, or you might find letters are missing.
  • A dark or blind spot in your central vision as the hole gets bigger.

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