Macular hole is a full-thickness defect in the central retina that causes decreased central vision.  A macular hole develops typically from an age-related process in the eye.  When we are young, the vitreous gel is attached to the retina.  As we age, the vitreous gel begins to pull away from the retina.  If the vitreous gel does not let go of the retina but instead tugs to hard on the retina, then a macular hole can develop.

Macular holes typically do not improve with observation, and therefore vitrectomy surgery is usually recommended.  In this surgery, the vitreous gel is removed from the eye and a gas bubble is placed inside the eye.  The patient is asked to position with their face down for between 1 and 7 days.  The hole closure rate is between 95 – 99% with vitrectomy surgery.