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What Is a Macular Hole? Stages, Symptoms, and Other FAQs

Are you curious about macular hole stages? What about the recovery time from macular hole surgery? We’re answering these and other important FAQs with helpful information that can hopefully help guide you through a macular hole diagnosis.

Keep reading to get a better understanding of the basics, and please reach out for more information or to schedule a consultation with a Mid Atlantic Retina specialist.

What Is a Macular Hole?

A macular hole is an eye condition that occurs in the macula, a small area located in the center of the retina.

The specific purpose of the macula is to convert light into neurological signals, which are then processed by your brain and converted into images. However, the very center of the macula is also the thinnest part of the retina, making it susceptible to holes, particularly as a person ages.

What Are Common Macular Hole Causes?

Age is the most common of macular hole causes because as the vitreous gel deteriorates with age, it separates from the macula. In some individuals who have an abnormally strong adhesion between the macula and vitreous, this separation can result in the formation of a hole. This is why macular holes are more common in those 55 years of age and older.

Other potential causes of macular holes include:

The primary risk factors for macular holes are aging, myopia, trauma, and uveitis (eye inflammation). Macular holes are also more likely to happen in women than men.

What Macular Hole Symptoms Are There?

Some macular holes do not cause any symptoms at all. However, those that do tend to cause complications like:

  • Blurred or distorted vision
  • Loss of central vision

Symptoms may come on gradually and may be more or less severe depending on the individual and the extent of the hole. They can also be caused by other retinal disorders. In any case, it is recommended that you seek treatment from a retinal specialist at the first sign of macular hole symptoms.

What Are Macular Hole Stages?

There are historically four macular hole stages:

  • Stage 1 – Small, often non-visible foveal detachments. These may close on their own, however, more than half will progress in size.
  • Stage 2 – A small hole with a full-thickness defect. These progress to Stage 3 in about 70% of cases without treatment.
  • Stage 3 –  A larger hole with a full-thickness defect in which the vitreous gel is still attachedo the optic disc.
  • Stage 4 – A larger hole with a full-thickness defect that has undergone vitreous separation from the optic disc.

Left untreated, later-stage macular holes can lead to various complications, including partial or full vision loss.

Can a Macular Hole Repair Itself?

Yes, on rare occasion In some cases, small stage 1 or stage 2 macular holes can spontaneously close without surgery or another intervention. With the spontaneous closure of a macular hole, vision typically improves over the course of one year.

What Is the Treatment for a Macular Hole?

When necessary, macular holes are treated via a surgical procedure called a vitrectomy.

A vitrectomy is a quick and safe procedure during which your retinal specialist will remove the vitreous gel from your eye to access the retina and then manually repair the hole in the macula. While the vitreous gel does not regenerate after surgery, it is no longer necessary for proper eye functioning after a certain age, and the body produces a fluid that replaces the vitreous.

As with any surgical procedure, there are some risks with a vitrectomy, including infection, bleeding, or retinal detachment. Talk to your Mid Atlantic Retina specialist to learn about potential complications you may be at risk for.

How Long Does It Take to Recover from Macular Hole Surgery?

Initial healing from macular hole surgery begins in the first several weeks, however the final visual outcome may not be realized for months to a year. A gas bubble is usually placed in the eye at the end of the vitrectomy surgery which gradually dissipates over one to two months. Acute symptoms of healing, such as discomfort, usually goes away within a few days to weeks of the completed procedure.

Contact Mid Atlantic Retina to Discuss Your Treatment Options

For eye exams, diagnostics, and retinal treatments, including vitrectomies, our Mid Atlantic Retina team is here to help. Our board-certified retinal surgeons and physicians are leaders in the field of retinal disease and are here to help you navigate any retinal condition you may be facing.

Call us today at 800-331-6634 or fill out an online form to learn more or to schedule your first appointment.