Macular hole

What is it?

The retina is the light-sensitive layer of cells that lines the back of the eye. At its centre is an area called the macula. It’s the part of the retina that’s most densely packed with ‘photoreceptor’ cells. We use the macula for seeing in colour and fine detail. A macular hole is a small break or tear in the macula.

  • Causes

    The middle of the eye is filled with a clear jelly called vitreous humour. As we age, the jelly starts to pull away from the retina and sometimes it will take some of the macula with it, leaving a macular hole.

    We don’t know exactly why macular holes develop, but some things make it more likely. Older age, being female and being very short-sighted all affect the chances.

  • Symptoms

    Symptoms of macular hole include central vision becoming blurred or distorted. It may become difficult to read or see well enough to drive. Objects may seem to be smaller than they should be. Eventually a dark spot may develop at the centre of your field of view.

    Macular hole usually only affects one eye at a time.

  • Treatments

    Options for treating macular hole depend on whether the hole is still in the early stages, how big it is how it happened. Sometimes, an eye injection with the drug Ocriplasmin can help stop the vitreous jelly from pulling at the retina. If this doesn’t work or if the hole is at a later stage, then keyhole surgery can help close the hole in the macula.

    Surgery involves removing the vitreous gel and injecting a gas bubble into its place. The gas expands and presses the macula back down so that it can heal in place. The surgery sometimes involves peeling away a very thing membrane that sits on top of the retina.

    Once the gas bubble has disappeared, if the macular hole has closed vision can continue to slowly improve over time but is unlikely to ever be as good as before the hole.

  • Research

    Macular hole research is focused on developing the best ways to close the hole with the least damage to the light-sensitive photoreceptor cells.

    Read our research projects
  • Clinical trials

    You could play an important part in eye research by being a participant in clinical research study that may benefit many people. You could even help shape clinical research by becoming more actively involved and having a say. Patients, carer, or anyone with an interest can help.

    What are clinical trials

    Clinical trials are research studies that find out if a medical strategy, treatment, or device is safe and effective for humans. They are a key research tool for improving medical knowledge and patient care. The people who carry out research are mostly the same doctors and healthcare professionals who treat people. Their aim is to find better ways of treating patients and keeping people healthy.

    Taking part

    Here are some ways to find out about research projects and clinical trials that you can get involved in.

    UK Clinical Trials Gateway

    The UK Clinical Trials Gateway run by the National Institute for Health Research (NIHR) provides easy to understand information about clinical research trials running in the UK, and gives to a large range of information about these trials. It is designed to enable patients and clinicians to locate and contact trials of interest. Visit their website and select the eye condition that you are interested in.

    NIHR Clinical Research Network Portfolio

    The NIHR Clinical Research Network Portfolio is a database of high-quality clinical research studies in England, Northern Ireland, Scotland and Wales. Within this the Ophthalmology Specialty Group supports a national portfolio of research studies in ophthalmology and the vision sciences. See their website for details.

    If you wish to join a trial it is always best to discuss this with your doctor or clinical team first.

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