Eye Conditions

Macular hole

A macular hole is a small break in the centre of the macula — the part of the retina responsible for your sharp, central vision. It sounds alarming, but it's a well-understood condition that can be treated, and the earlier it's assessed the better the outlook. Diagnosing and managing macular problems is one of Dr Leong's areas of special expertise.

What it is

The macula gives you the fine, straight-ahead vision you use for reading, recognising faces and detailed work. A macular hole is a small gap that opens right at its centre.

It most often happens as part of normal ageing: the vitreous gel inside the eye slowly separates from the retina, and as it does it can tug on the macula and open a hole. It usually affects one eye, and it's more common after the age of 60 and in women.

What you might notice

Blurred or distorted vision in the very centre of one eye
Straight lines looking wavy or bent
A grey or dark patch in the middle of your vision
Difficulty reading or seeing fine detail
Side (peripheral) vision staying normal

Recognise these? Book a consultation and we'll help you get to the bottom of it.

When to seek help urgently

A sudden dark curtain, a shower of new floaters, or flashing lights can be signs of a retinal tear or detachment rather than a macular hole — these need same-day assessment. If in doubt, contact us or go to your nearest eye emergency service.

What causes it

Most are age-related, caused by the normal shrinking and separation of the vitreous gel pulling on the macula.

Less commonly they follow a significant eye injury, long-standing swelling of the retina, or high short-sightedness.

How we help

Diagnosis is straightforward and painless: an OCT scan gives a detailed cross-section of the macula that confirms the hole and shows its size and stage — which guides the best treatment.

Most macular holes are treated with a vitrectomy, a procedure that releases the tension on the macula and places a gas bubble to help the hole close, often with a period of face-down positioning afterwards. Dr Leong will assess your eye, explain what stage it's at, and coordinate timely surgery with a vitreoretinal surgeon — timing matters, so an early assessment is worthwhile.

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Common questions

Can a macular hole heal on its own?

A small number of very early, small holes can close by themselves, but most do not. Because the outlook is generally better the sooner a hole is treated, it's best to have any sudden central distortion assessed rather than waiting to see if it settles.

Is a macular hole an emergency?

It's not usually a same-day emergency in the way a retinal detachment is, but it should be assessed promptly — within days to a couple of weeks — because earlier treatment tends to give a better result. A sudden curtain over your vision or a burst of floaters and flashes does need urgent care.

Will surgery restore my vision?

Vitrectomy successfully closes the great majority of macular holes, and most people regain useful central vision, though the improvement is gradual over months and the final result depends on the size of the hole and how long it was present. Dr Leong will give you a realistic idea for your eye.

Does a macular hole cause blindness?

No — it affects your central vision in the one eye, not your side vision, so it doesn't cause total blindness. It can make reading and detailed tasks difficult, which is why timely assessment and treatment matter.

This page is general information, not medical advice, and doesn't replace a consultation. For anything specific to your own eyes, call us for advice or to book an appointment with Dr Leong on 04 470 7663.

Ready to see clearly?

Book a consultation with Dr Leong, or call the clinic to talk it through. We're here to help you see your very best.

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