Sometimes a retinal hole develops in the center of the macula. This is called a Macular Hole and can be caused by vitreous traction. This traction can be caused from trauma, an Epi-Retinal Membrane, Vitreous Detachment or for unknown reasons.
Symptoms of a Macular Hole
The vitreous overlying the macula may first contract and pull up the center of the macula. When this happens, the patient may notice a slight distortion or reduction in vision. As the Vitreous continues to pull, the macula may develop a tiny hole. With time, this hole usually becomes larger. When a macular hole occurs, central or detail vision is lost. When a patient develops a macular hole in one eye, there is an increased risk that a macular hole could develop in the other eye.
Once a macular hole develops, vitrectomy surgery may improve the vision. The vitreous is removed and gas or silicone oil is placed in the eye to help the macula remain in place, and to allow the hole to heal and close. Following surgery, the patient is usually required to remain in a face down position for seven days.
Not all patients with a macular hole will see better following surgery. The complications are very much the same for any vitreous surgery and may include retinal tears and detachment, infection, and reopening of the hole. Cataract occurs in almost all cases within one to two years following surgery. These complications may result in mild to total loss of vision, though vision-loss complications are rare.