What Is a Macular Hole?

Eye doctors check for macular degeneration during eye examinations. -Oxford-


Is a macular hole the same as macular degeneration?


A macular hole is not the same thing as macular degeneration. Although both eye diseases affect the macula, they are completely different problems. The macula is the part of the retina that allows us to see sharp detail. Your macula is responsible for your central vision that allows you to complete tasks such as reading, working on the computer and driving.

Macular Hole

A macular hole is a hole that develops in the macula. In the early stages of macular hole, vision may seem distorted or blurred. In the later stages, however, a macular hole can produce extreme loss of central vision while peripheral vision remains intact.

Although a macular hole can develop from trauma or be secondary to other eye diseases, it most often occurs due to aging changes in the vitreous, the gel-like substance that fills the posterior cavity of the eye. The vitreous is attached to the retina tightly in certain places with tiny fibers. As we age the vitreous can liquefy, shrink and contract. When these changes occur, the vitreous may pull or tug on the retina, possibly creating a retina tear, or in this case it can pull on the macula, first creating a macular cyst that may develop into a hole.

Macular Degeneration

Macular degeneration most often occurs due to aging changes in the retina.

However, many times the risk of developing the disease is genetically inherited, with certain environmental risk factors that make the risk of developing it even higher. Risk factors are age, race, skin color, gender, smoking, obesity, sun exposure, sleep apnea and family history.

With macular degeneration, the pigmentary cells in the macula begin to deteriorate.

Cellular debris builds up, causing drusen. In some cases, fragile blood vessels begin to grow and leak blood and fluid. As this occurs, vision begins to degrade. Some patients have very little vision loss while others can develop totally loss of central vision.


Sowka, Joseph W, Andrew S Gurwood and Alan G Kabat. The Handbook of Ocular Disease Management, a supplement to Review of Optometry. 15 April 2010.

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