Causes of a Macular Hole

While they are not direct causes of a macular hole, certain eye conditions -- such as diabetic retinopathy or Best's disease -- do put people at a greater risk for developing a macular hole. Vitreous pulling is another factor that can result in a macular hole.

What Causes a Macular Hole?

Macular holes can be the result of:
 
  • The vitreous pulling on the retina
  • Certain eye conditions.
     
Vitreous Pulling
Most of the eye's interior is filled with vitreous, a gel-like substance that fills about 80 percent of the eye and helps it maintain a round shape. The vitreous contains millions of fine fibers that are attached to the surface of the retina.
 
As we age, the vitreous slowly shrinks and pulls away from the retinal surface. Natural fluids fill the area where the vitreous has contracted. This is normal. In most cases, there are no adverse effects. Some patients may experience a small increase in floaters, which are little "cobwebs" or specks that seem to float about in your field of vision.
 
However, if the vitreous is firmly attached to the retina when it pulls away, it can tear the retina and create a macular hole. Once the vitreous has pulled away from the surface of the retina, some of the fibers can remain on the retinal surface and can contract. This increases tension on the retina and can lead to a macular hole. In either case, the fluid that has replaced the shrunken vitreous can then seep through the hole onto the macula, blurring and distorting central vision.
 
Certain Eye Conditions
Macular holes can be associated with various eye conditions. While a macular hole is not specifically caused by these eye conditions, they increase a person's chance of developing one. Risk factors for macular holes include some of the following conditions:
 

Macular Holes

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