Macular Holes

Macular holes can cause decreased central vision, and/or distortion. The macula is the central portion of the retina, which lines the inside of the back of the eye and acts like a film in a camera, receiving the light that enters the eye and creating the image that is then transmitted to the brain by the optic nerve.

Macular holes only affect central Picture of Macular Hole VMR Institute Huntington Beach CA 92647vision. The macula is responsible for central vision and seeing small details. It is therefore important in reading and driving.

Macular holes usually occur in one eye and are more common in women than men.

Cause of Macular Hole

During aging, there are molecular changes in the vitreous that cause the gel to become liquefied. As a liquid, the vitreous can no longer fill the center of the eye and collapses, pulling away from the macula.


The result in called Posterior Vitreous Detachment (PVD), which is associated with “floaters“. This happens to almost everyone if they live long enough and usually occurs without any further problems.


But in some people, PVD does not occur normally, resulting in what is called anomalous PVD. Anomalous PVD can cause a variety of disorders that affect vision.

In some people, the outer layer of the vitreous splits and leaves a thin layer attached to the macula. This is called vitreoschisis. This sheet or membrane can disturb the macula, causing a hole to open in the center, called a Macular Hole.  Macular Hole disturbs central vision by causing a central blind spot and distortions.


Treatment for Macular Hole

Visual acuity (the ability to read the letters on the eye chart) is often at the level of legal blindness. Fortunately, this can be cured at the VMR Institute.

The cause of the macular hole is the abnormal sheet membrane that is attached to the macula. The cure for a macular hole is surgery to remove this membrane and fill the eye with a temporary air/gas bubble, which the body will absorb on its own.


Dr. Sebag employs sutureless techniques using 25 gauge microsurgery instruments to cure macular holes under local anesthesia in an ambulatory surgery center, so hospitalization is not required.


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