Macular Hole

A macular hole is a small break in the macula, which is part of the retina. A macular hole is not the same thing as macular degeneration, although both have similar symptoms. Certain risk factors for a macular hole include an injury to the eye, extreme nearsightedness, and diabetic retinopathy. When this condition occurs, a surgical procedure called a vitrectomy may be necessary to help improve vision.

 

What Is a Macular Hole?

A macular hole is a small break in the macula, which is located in the center of the eye's light-sensitive tissue called the retina. The macula provides the sharp, central vision we need for reading, driving, and seeing fine detail.
 
A macular hole can cause blurred and distorted central vision. Macular holes are related to aging and usually occur in people over age 60.
 

Understanding the Eye

In order to understand a macular hole, it is helpful to understand the parts of your eye involved with sight. These structures include the cornea, iris, pupil, lens, macula, and retina.
 
Your cornea is a thin, clear layer on the outside of your eye. The iris, or the colored part of your eye, is a muscle that controls the amount of light going through your pupil -- the round opening in the center of your eye. Behind the iris sits the lens, which is just larger than your pupil. The iris is enclosed by a thin, clear capsule that holds the lens in its proper place.
 
When light enters your eye, the cornea and lens form the light rays into a beam of light that is focused directly onto your retina, the light-sensitive tissue at the back of the eye. The retina instantly converts light, or an image, into electrical impulses. The retina then sends these impulses, or nerve signals, to the brain through the optic nerve. The optic nerve is a bundle of more than one million nerve fibers connecting the retina to the brain.
 
The macula is located in the center of the retina. It is made up of millions of light-sensing cells that help to produce central vision.
 
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.
 
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Written by/reviewed by: Arthur Schoenstadt, MD
Last reviewed by: Arthur Schoenstadt, MD