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» Everything you need to know about macular holes

Everything you need to know about macular holes

A round retinal break in the macula, the macular hole causes a significant loss in visual acuity, which can be disabling in everyday life. Discover the causes and consequences of this eye condition.


What is a macular hole?


A macular hole is a tear in the center of the retina, the macula. Typical onset is from the age of 50, and the condition is more common in women. Over time, the vitreous body, which is the transparent gel that fills the eye, shrinks and detaches itself from the back of the eye. This normal phenomenon can, however, have unpleasant consequences when overly strong traction causes the retinal tissue to tear.


In this case, the fluid can leak under the macula and gradually tear away the edges of the hole, making it bigger. This condition manifests itself through symptoms that are quite varied – from the total absence of signs, to a severe loss of vision.


  • Metamorphopsia
  • Macropsia
  • Micropsia
  • Watzeke-Allen sign (lines that appear broken or kinked in the center)


The different types of macular hole


There are several different types of macular hole, according to its causes:


  • Idiopathic or aged-related
  • Myopic
  • Traumatic


Depending on the thickness of the damaged retina, we can also distinguish between a full-thickness macular hole and a lamellar macular hole.


What kinds of treatment are there?


Unfortunately, there is currently no known way of preventing the formation of a macular hole. It is, however, essential that the condition is diagnosed early so the patient can benefit from effective surgical treatment. 


The main treatment for a macular hole is based on a surgical operation called a vitrectomy. It involves microscopic incisions that don’t require sutures, and that make it possible to eliminate the structures at the origin of the traction on the macula. A bubble of gas is then injected into the vitreous cavity to facilitate the closure of the macular hole.


In all cases, it is important to attend regular eye screening to ensure this condition is detected quickly and to benefit from treatment, which offers very promising results.