Living with a macular hole

If you’re living with a macular hole, your central vision will probably be affected. It can cause blurred and distorted vision in the affected eye and even progress to cause a blank spot but doesn’t affect peripheral vision.

Surgery can repair a macular hole, and early treatment leads to better outcomes. A macular hole is estimated to occur in 3 in 1,000 people aged 55 or older (Source: Medscape). Being diagnosed with a condition that affects your sight can feel very worrying, especially if you experience symptoms like these.

Fortunately, surgical treatment is available to repair a macular hole, and it's effective for 90% of people who've had the condition for less than six months. 

Managing life with a macular hole

With a macular hole, early treatment has a better success rate than if surgery happens at a later stage, for example, if you've had a macular hole for over a year. That's one reason why regular eye tests are important; many eye conditions can be detected at a routine eye test, allowing prompt treatment. 

In rare cases, a macular hole can heal itself. Therefore, your ophthalmologist may monitor you initially, before recommending treatment. If it doesn't heal itself, then surgery is usually recommended. 

It can take a few months to recover fully from surgery, but a vitrectomy will result in improved vision for most people. Even if this isn't the case, it should stop the condition from getting any worse. If you're having trouble with your vision since being diagnosed with a macular hole, there are many ideas to help you. For example, magnifying lenses and better lighting can make it easier to read and see details. Try some of our ideas for adapting to central vision changes.

Macular hole and driving 

Having a macular hole can affect your central vision, causing symptoms such as blurred or distorted vision and straight lines or objects appearing wavy or crooked. At an advanced stage, a macular hole can cause a black patch at the centre of your vision. Because of this, it may affect your ability to drive safely. The DVLA has a minimum required standard of vision for driving. Speak to your ophthalmologist for advice, based on how the condition is affecting you.

Can you fly with a macular hole?

You must not fly for up to three months after surgery to treat a macular hole. The gas bubble inserted into the eye to help recovery expands at high altitude, leading to very high pressure, which is not only painful but can lead to permanent vision loss. Other activities to avoid include travelling to high altitude places on land and scuba diving.

Can you work with a macular hole?

Being diagnosed with a macular hole doesn't necessarily mean you can't work. The effect on your central vision depends on the stage of the condition and the size of the hole.

If your sight is affected, it may be a good idea to tell your employer. There could be things they can do to help you at work, and it's their responsibility to make reasonable adjustments. We have lots of ideas for coping with changes to your central vision.

It’s also a good idea to tell work if you’re going to have surgery so that you can plan ahead together. Everyone having macular hole surgery will need some time off to recover.

Straight after surgery, you'll be taking regular eye drops. Some people also need to spend time in a face-down position called posturing to help their postoperative recovery. The length of time off you need will depend on the type of work you do. For example, if your job involves driving, you may need more time off. You can discuss returning to work with your ophthalmologist at a check-up appointment after the surgery.

Get support for living with a macular hole

If you or a family member are diagnosed with a macular hole, there is plenty of practical advice to help manage it. But sometimes, what you really need is someone to talk to about the emotional side of being diagnosed with an eye condition.

You might benefit from some skills and approaches to make the most of your vision while you wait for surgery or while recovering from it.

Support organisations

• Macular Society

The Royal College of Ophthalmologists champions excellence in the practice of ophthalmology and is the only professional membership body for medically qualified ophthalmologists. The RCOphth is unable to offer direct advice to patients. If you’re concerned about the health of your eyes, you should seek medical advice from your GP, optometrist or ophthalmologist.

For more support...