Macular hole

What is a macular hole?

A macular hole is a small break in the macula, located in the centre 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.

Symptoms

The most common symptom of macular hole is a decline in the central (straight-ahead) vision of the affected eye.

This can occur as:

• Blurring
• Distortion (straight lines appearing wavy)
• A dark spot in the central vision.
• The degree to which vision is affected will depend on the size and location of the macular hole, as well as the stage of its development.

Causes

The vast majority of cases develop spontaneously without an obvious cause. For this reason, there is currently no effective way to prevent their formation and development. If a macular hole develops in one eye, there is a 5% to 15% risk of one developing in the other eye.

Risk factors

Macular holes are most common in people age 60 or older and seem to be more common in women.

Age is the primary risk factor for the development of macular pucker, but additional risk factors include:

• History of a retinal tear or detachment
• Diabetes
• Retinal venous occlusions
• Inflammation in the eye (uveitis)

Is a macular hole the same as age-related macular degeneration?

No. Macular holes and age-related macular degeneration are two separate and distinct conditions, although the symptoms for each are similar. Both conditions are common in people age 60 and over. Our eye doctors can tell the difference with the help of our state of the art
equipment.

Diagnosis

Optical coherence tomography (OCT) is the current gold standard in the diagnosis, staging, and management of macular holes. This quick, non-invasive imaging technique allows for evaluation of the macula in high resolution using reflected light, and helps your doctor differentiate a hole from other eye conditions with similar symptoms.At Vista Eye Clinic, we have an OCT machine in each of our practices in Naas and Ranelagh.

TREATMENT FOR A MACULAR HOLE

Although some macular holes can seal themselves and require no treatment, surgery is necessary in many cases to help improve vision
Some patients decide not to have an operation and accept the poor central vision in the affected eye. This is reasonable, especially if the vision in the other eye is not affected. There is no “right” or “wrong” decision as every person has different needs and priorities.

At Vista Eye Clinic, we have forged a relationship with some of the leading eye surgeons who specialises in treating this condition and we can liaise with them to get you an expert opinion.