Most of the eye's interior is filled with vitreous, a
gel-like substance that fills about 80 percent of the eye and helps it
maintain a round shape. The vitreous contains millions of fine fibers that
are attached to the surface of the retina. As we age, the vitreous slowly
shrinks and pulls away from the retinal surface. Natural fluids fill the
area where the vitreous has contracted. This is normal. In most cases, there
are no adverse effects. Some patients may experience a small increase in
floaters, which are little "cobwebs" or specks that seem to float about in
your field of vision.
However, if the vitreous is firmly attached to the retina
when it pulls away, it can tear the retina and create a macular hole. Also,
once the vitreous has pulled away from the surface of the retina, some of
the fibers can remain on the retinal surface and can contract. This
increases tension on the retina and can lead to a macular hole. In either
case, the fluid that has replaced the shrunken vitreous can then seep
through the hole onto the macula, blurring and distorting central vision.
Macular holes can also occur from eye disorders, such as
high myopia (nearsightedness), macular pucker, and retinal detachment; eye
disease, such diabetic retinopathy and Best's disease; and injury to the
eye.
Symptoms:
Macular holes often begin gradually. In the early stage
of a macular hole, people may notice a slight distortion or blurriness in
their straight-ahead vision. Straight lines or objects can begin to look
bent or wavy. Reading and performing other routine tasks with the affected
eye become difficult.
Types:
There are three stages to a macular hole:
- Foveal detachments (Stage I).
Without treatment, about half of Stage I macular holes will
progress.
- Partial-thickness holes (Stage II). Without
treatment, about 70 percent of Stage II macular holes will progress.
- Full-thickness holes (Stage III).
The size of the hole and its location on the retina
determine how much it will affect a person's vision. When a Stage III
macular hole develops, most central and detailed vision can be lost. If
left untreated, a macular hole can lead to a detached retina, a
sight-threatening condition that should receive immediate medical
attention.
Associated Retinal
Consultants P.C. provides this on-line information for educational
and communication purposes only and it should not be construed as personal
medical advice. Information published on this website is not intended to
replace, supplant, or augment a consultation with an eye care professional
regarding the viewer/user's own medical care.
Associated Retinal Consultants P.C. disclaims any and all liability
for injury or other damages that could result from use of the information
obtained from this site.
