Macular holes usually occur due to stress on the macula. When we are young, the vitreous (the clear gel-like substance in the eye) is attached to the retina and macula. As we age, at some point in our lives, the vitreous will usually detach from the macula and the posterior retina, which is called a posterior vitreous detachment (PVD). PVD can cause symptoms of floaters and flashes for a few weeks, but in most cases does not cause any major problems. However, in some patients, the process of PVD causes stress on the macula, causing a macular hole to form.
Another cause of macular holes is high myopia (short-sightedness), where the elongation of the eyeball causes stretching and thinning of the retina, and puts stress on the macula, causing a hole to form. Occasionally, macular holes can also be caused by physical trauma to the eye.
Macular Hole
Optical coherence tomography (OCT) scan showing a Macular Hole
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