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Why do people get macular holes?

David R. Demartini, MD
Ophthalmology
The macula is the central area of the retina where all the fine vision is processed. The vision on the eye chart is all seen through the macula. Macular holes are a separation of the retina either from itself or the underlying choroid. This can be a slow change starting with blurring or more dramatically with a loss of central vision. Often the overlying vitreous strands pull on the macula to cause a hole. Trauma, diabetes and retinal membranes can also cause macular holes. If left untreated, vision can be permanently lost or a retinal detachment can develop.
Some macular holes require surgery to improve. Occasionally they can stop or reverse themselves. A few are not surgical candidates because the patient's vision is too good to justify surgery. 

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