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A macular hole is a small hole that develops in the macula, a very small spot in the center of the back of the eye (retina).

Who is more at risk?


Macular holes are often related to age and more likely in people over 60 but are different from other age related eye disease called macular degeneration which occurs often more frequently amongst people over 60. Statistically women have slightly more risk for macular holes than men.

Why do Macular holes happen?

Your eye keeps its shape through a rather thick, gel-like material called the vitreous humor (also called the vitreous body or the vitreous) found at the back of the eye. With aging, the clear vitreous shrinks and becomes more liquefied causing it to slosh around.

The shrinkage can tear off small pieces of the retina causing a hole. If this missing piece of retina is in the macula, it’s called a macular hole. Another cause is vitreous shrinkage which is when the strands stay attached to the macula and breakaway from the peripheral retina, causing tractional forces that causes macular hole. In either case, the missing part of the macula causes decreased vision.

macular hole.jpg

“This image was originally published in the Retina Image Bank® website.

Author: Jeffrey G. Gross, MD, Macular hole. Retina Image Bank. 2012; 929. © the American Society of Retina Specialists."

Macular Hole Repair


In mild cases no treatment may be needed but it is important to be observed to ensure that the vitreomacular traction is not getting any worse and directly affecting your vision. In some cases, it may resolve itself on its own. It is important to get follow up visits to ensure your condition is monitored and observed closely.

In more severe cases surgery may be needed as vitreomacular traction can lead to vision-threatening retinal conditions including:

  • Macular puckering

  • Macular hole

  • Cystoid macular edema


In these circumstances a vitrectomy may be recommended to return the macula to its normal shape. This involves using tiny instruments to remove the vitreous from the eye and replace it with a saline fluid. This procedure relieves the traction that is causing damage to the macula.

To learn more about treatment options or any concerns you may have relating to Vitreomacular Traction please schedule a visit with Dr El Annan at the Annan Retina Eye Center. Please call 346-22A-NNAN to speak to a member of staff who will be more than happy to help you.

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