A macular hole is a circular defect in the macula (the central vision area of the retina at the back of the eye). This hole causes you to lose your central vision, which initially becomes distorted and blurred; and as the hole progresses, a blind spot may develop in the central vision affecting you at both near and distance.

What causes flashes?

  • A macular hole can develop due to the vitreous, the gel-like substance in the middle cavity of your eye, pulling on the macula (the central vision area of the retina at the back of the eye). As you age, the vitreous gel contracts and pulls on the retinal tissue and if the vitreous gel sticks to the macula and is unable to pull away cleanly, a macular hole forms.



  • Vitrectomy surgery is the most effective treatment to close a macular hole and possibly improve vision. The surgery removes the vitreous gel and scar tissue that are pulling the retina, and then the eye is filled with a special gas to help flatten the macular hole. In order for the gas to close the hole, you must maintain a constant face-down position after surgery, which can range from a few days to a few weeks, depending on the gas used and your surgeon’s recommendations. Macular Hole closure often depends on how well this position is maintained after surgery.
  • If you have a gas bubble, you cannot fly in an airplane or go to extremely elevated areas above sea level as this can cause a dangerous rise in eye pressure due to the gas bubble expanding. You must also not undergo general anesthesia using nitrous gas as this can also cause a dangerous rise in eye pressure.
  • As the gas dissipates and the hole closes, your vision may slowly improve. The visual outcomes often depend on the initial size of the hole and how long it was present before surgery and the amount of visual recovery may significantly vary between patients.

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