© the American Society of Retina Specialists. This image was originally published in the ASRS Retina Image Bank.
This will allow the bubble to gradually dissolve and be replaced by natural eye fluids. The patient may be asked to maintain a face-down position for several days, and in some cases up to 2 weeks, depending on the characteristics of the macular hole. In this surgical procedure, the vitreous gel is removed to stop it from pulling on the retina, and most commonly a gas bubble is placed in the eye to gently hold the edges of the macular hole closed until it heals. Vitrectomy is the most common treatment for macular holes. No laboratory tests are needed in cases of idiopathic macular holes (those without a known cause). 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. Optical coherence tomography (OCT) is the current gold standard in the diagnosis, staging, and management of macular holes (Figure 1). Retinal detachment Genetics, environmental factors, and systemic causes don’t seem play a role in macular hole formation.Macular pucker: formation of a scar tissue layer over the macula that can warp and contract, causing wrinkling of the retina.High degree of myopia (nearsightedness).Injury or trauma: some young people develop macular holes after blunt trauma.With normal aging, the vitreous can shrink and pull away from the retina, sometimes creating a macular hole in the process. Vitreous traction: the vitreous is the “gel” that fills up the inside of the eye.Several conditions can increase the risk of macular hole formation, including: If a macular hole develops in one eye, there is a 5% to 15% risk of one developing in the other eye. For this reason, there is currently no effective way to prevent their formation and development. The vast majority of cases develop spontaneously without an obvious cause. Macular hole commonly affects people over the age of 55 and most often occurs in women. 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. Distortion (straight lines appearing wavy).The most common symptom of macular hole is a gradual decline in the central (straight-ahead) vision of the affected eye.
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