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.
A macular hole can cause blurred and distorted central vision. Macular holes are related to aging and usually occur in people over age 60. The condition can be disturbing as one of your eyes suddenly becomes distorted and blurry. It starts developing with decrease in vision in one eye.
There are three stages to a macular hole, namely foveal detachments, partial-thickness holes and full-thickness holes. Foveal detachments, stage I of macular hole, is the phase when macular holes will progress. Partial-thickness hole is stage II of macular hole; in this phase about 70 percent of Stage II macular holes will progress. Full-thickness holes (stage III) can have a big impact on the retina and vision. One can also lose vision in this stage. When left untreated, a macular hole can lead to a detached retina.
Human eye is filled with a gel-like substance called vitreous. With age, the vitreous gel shrinks and pulls away from the macula without having an impact on your sight. However, in some case the vitreous gel sticks to the macula and is unable to pull away. What happens next is that the macular tissue stretches or tears to form a hole.
Macular holes can also occur if you have eye disorders such as high myopia (nearsightedness), injury to the eye, retinal detachment and macular pucker. If you have a macular hole in one eye, there is a chance that a macular hole will develop in your other eye over your lifetime.
Some macular holes can seal themselves without any medical treatment. However, surgery is necessary in many cases to help improve vision. The surgical procedure called a vitrectomy is the treatment approach. In the medical procedure, the vitreous gel is removed and replaced with a bubble containing a mixture of air and gas. The bubble is like temporary bandage that holds the edge of the macular hole in place as it heals.
After surgery, patients must be in a face-down position, even for weeks in some cases. This is necessary to allow the bubble to press against the macula and be gradually reabsorbed by the eye and seal the hole.
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