Overview

A macular hole is a small gap that opens at the centre of the retina, in an area called the macula. 

If you have a macular hole, your ophthalmologist (eye doctor) may recommend surgery to improve your eyesight. 

Problems caused by a macular hole

People with a macular hole will probably have changes in the central part of their vision. These changes can range from straight lines looking wavy in the early stages, to a small blank patch in the centre of vision in the late stages. You might have noticed that you had trouble reading small print or that there is distortion when you look at a printed page. 

If you do not have treatment

If you do not have any treatment for your macular hole, your central vision will generally get worse in the affected eye, but you will not lose all of the vision in your eye. 

Outcomes of macular hole surgery

The most important factor in predicting if the surgery will work is the length of time that you have had the hole.

For patients who have had holes for less than 6 months, about 9 out of 10 operations will be successful.

For patients who have had a hole for a year or more, only about 6 in 10 operations will be successful.

Most people have some improvement in vision after they have recovered from the surgery. For other people the operation’s main aim is to stop the sight becoming any worse. Your doctor will speak with you in more detail about what results you can expect from the surgery. 

Risks of macular hole surgery

Like any surgery, there are some risks associated with macular hole surgery that you need to be aware of. We will explain these risks to you in clinic. 

Failure to close the macular hole

Depending on how long you have had a macular hole, the risk of the operation not closing the hole is 5 to 50 out of 100 patients (5% to 50%). We will talk to you in more detail about this when you sign the consent form.

If there are no other complications, failure does not usually make the vision worse. If the operation fails to close the hole we will discuss with you if a different operation would be helpful.

Retinal detachment

This happens in about 1 of every 100 cases. This is a serious complication where the retina comes away from the inside wall of the eye. It can cause blindness in the affected eye, but in most cases it can be successfully treated, and vision restored. If your retina detaches, you will notice sudden loss of vision in the eye, which is similar to a curtain being drawn across the eye.

Infection

An infection is very rare. This occurs in about 1 of every 1,000 macular hole surgeries and can cause blindness. If it does happen, treatment would involve injections into your eye and high doses of antibiotics.

Other risks 

Some other problems, such as glaucoma or bleeding (haemorrhage) can occur. These tend not to be as severe or problematic as retinal detachment or infection.

If you would like more information, or have any concerns about the risks associated with surgery, please ask your doctor or nurse.

Giving your permission (consent)

We want to involve you in decisions about your care and treatment. If you decide to have the procedure or treatment, we will ask you to sign a consent form. This says that you understand what is involved and agree to have the treatment.

Read more about our consent process.