A macular hole is a small break or tear in the macular, which is the central part of your vision.

The eye is filled with a clear-like jelly substance that is lined by the retina. As we age, this gel starts to separate from the retina, resulting in a posterior vitreous detachment (PVD). This usually happens without any complications. However, in some cases, as the gel starts to separate from the retina, it pulls abnormally and can cause a hole in the retina. Although some macular holes may also be caused by eye trauma, most retinal holes occur spontaneously due to a PVD.

To diagnose a macular hole, your ophthalmologist will review your symptoms and perform a comprehensive eye examination. This includes a dilated eye exam, vision testing, an OCT (optical coherence tomography), and a slip-lap examination. If other testing is required, we will do this on the day.

A macular hole can cause changes in your central vision. These changes can look like straight lines looking wavy or distorted, or a small black patch in the centre of your vision.

Other symptoms of a macular disease can include

• floaters,
• flashes of light
• sudden decrease in vision

Treatment

Treatment depends on the size and location of the hole. In some cases, small macular holes may not require immediate treatment and can be monitored over time. However, in most cases, a macular hole will get larger and distort vision, so treatment may be recommended. Surgical treatment attempts to fix the hole and prevent further complications.