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Educational content only
This page is general patient education, not medical advice. It does not diagnose conditions, recommend specific treatments for you, or replace a conversation with your eye care provider. Always consult a qualified clinician before making decisions about your eye health.
A macular hole is a small break in the center of the retina — the area that gives you sharp central vision. Modern surgery closes most holes and restores meaningful vision.
What helps
Here's the plan — and why it works.
Standard
Vitrectomy with gas
The retina surgeon removes the vitreous, peels the inner retinal layer to release traction, and fills the eye with a gas bubble that supports the hole while it closes.
After
Face-down positioning
Some surgeons ask patients to keep the head positioned so the bubble presses on the macula — usually for several days. Newer techniques may shorten or eliminate this step.
Drug option
Ocriplasmin injection
A medication that can release vitreous traction in select small holes. Lower success rate than surgery but avoids the OR.
After surgery
Cataract surgery
Vitrectomy accelerates cataract formation. Cataract surgery within a year or two of vitrectomy is common.
Come in promptly if
You notice new central blurring, a dark spot at the center of vision, or significant distortion. Smaller, earlier-treated holes have better surgical outcomes.
Common questions
Honest answers to common questions.
Will my vision come back?+
Most patients regain meaningful central vision after successful hole closure. The earlier and smaller the hole when treated, the better the result. Some baseline distortion can be permanent.
Why do I have to lie face down?+
The gas bubble rises in the eye. With your head face down, the bubble presses against the macula, holding the hole closed while it heals. Newer techniques and longer-acting gases have shortened or eliminated face-down time in many cases.
Can I fly with the gas bubble?+
No — flying with intraocular gas can cause severe pressure rise and vision loss. The gas dissolves on its own; your surgeon will tell you when air travel is safe (often 2-6 weeks).
Is the surgery painful?+
No. It's done under local anesthesia, often with sedation. Most patients are home the same day with minimal discomfort.
What's the success rate?+
Modern vitrectomy with peeling closes 85–95% of macular holes on the first attempt. Visual recovery continues over several months.