Fernández Vega Ophthalmological Institute - Macular hole - Instituto Oftalmológico Fernández Vega

macular hole

The macular hole is usually a consequence of aging, so it usually affects people over 60 years. The aging process has two concrete effects on the structure of the eye.



On the one hand, the macula, which is the central part of the retina, becomes increasingly thinner. On the other hand, the vitreous humour contracts: it is a gelatinous substance that normally occupies the entire interior of the eyeball. 


Throughout this process it is possible that part of vitreous humour remains attached to the macula instead of detaching itself, so that it pulls away. This, together with the thinning of the macula, assists the tension generated in producing the tear of the central part of the retina. A macular hole is a small break in the macula, the part of the eye responsible for central vision. In addition to age, myopia, certain eye injuries or a long-lasting ocular inflammatory process are other risk factors for suffering from a macular hole. 


In the initial phase of macular hole formation there is an alteration of the vision that results in blurred, hazy or undulating vision.  If this is enlarged further a black spot and distortion may appear in the central vision, which will be all the greater the larger the area of the macula that has been affected.
Any of these symptoms lead to immediate consultation with an ophthalmologist to perform an in-depth study of the structure of the eye and in the event of confirmation of the diagnosis, it can be treated immediately.


The treatment of the macular hole is always surgical and is performed by a procedure called vitrectomy, in order to detach the vitreous humour attached to the macula and repair the tear that has occurred.


Vitrectomy is a technique that allows access to the retina in order to eliminate vitreous humour remains that are attached to the macula. A gas or oil is then inoculated to fill the entire eyeball, so that it presses the macula by holding it in place, flattening it and allowing the repair of the macular hole.
During recuperation from this intervention, the patient must remain at all times face down for a period that will be determined by the ophthalmologist and may be one or more weeks. In addition, as long as there is no total resorption of the gas or oil introduced into the eyeball during the intervention, air travel or elevated height must be avoided to avoid an increase in intraocular pressure (IOP), which could have serious consequences. If you choose the oil incision, another surgery is required to remove it.

Results of the operation

Recover of visual capacity after vitrectomy will depend on the growth time of the macular hole and the extent of the macula that has been damaged.

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