Macular Hole
What is a Macular Hole?
A full thickness macular hole is a small round hole that develops in the centre of the macula, the highly specialised area of the retina responsible for detailed central vision. It can have a significant impact on central detailed vision reducing the ability to read and recognise faces. Macular hole is not the same condition as “macular degeneration.“
What Causes a Macular Hole?
Full thickness macular holes are caused by traction on the macula by the vitreous gel. Partial thickness (lamellar) macular holes often occur in association with epiretinal membrane.
What are the Symptoms of a Macular Hole?
Full thickness macular holes usually cause blurred vision and/or distortion. Partial thickness macular holes may have little effect on vision. Because macular holes only affect the very centre of vision, and the peripheral (side) vision remains normal, some people will not be aware of a problem unless they cover the other eye.
How is a Macular Hole Diagnosed?
Most full thickness macular holes are detected in patients who have noticed distorted or reduced vision. The gold standard for confirming the diagnosis is Optical Coherence Topography (OCT) which provides very detailed pictures of the macula. Partial thickness holes are commonly found incidentally.
How is a Macular Hole Treated?
Most full thickness macular holes require vitreoretinal surgery (pars plana vitrectomy). They can progressively get larger and worsen over time without treatment.
In contrast, most partial thickness macular holes do not have much impact on vision, do not progress and do not require surgical intervention.
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