Macular Hole Surgery: What to Expect Before, During, and After
If you’ve noticed a sudden blurry or distorted spot in the center of your vision, it could be more than just a change in your eyesight — it might be a macular hole. This small break in the central retina can significantly impact daily activities like reading, driving, or recognizing faces. Macular holes often develop with age, especially in adults over 60, but with timely diagnosis and treatment, most people experience meaningful improvement.
What is a Macular Hole?
The macula is the small, highly sensitive part of your retina responsible for sharp, central vision — the kind that lets you read, drive, and recognize faces. When a hole forms in this delicate area, it can distort or blur the image your brain receives. You might notice a dark or blank spot in the middle of your vision, while your side (peripheral) vision stays the same.
Macular holes usually develop as part of the natural aging process, when the eye’s gel-like substance (called the vitreous) pulls away from the retina. In some cases, that gentle tug can create a tiny tear that gradually widens over time. Because the damage happens at the very center of your vision, even a small hole can have a big impact on daily life.
Macular Hole Surgery
Not every macular hole requires surgery right away. In rare cases, a small, early-stage hole may close on its own. But when vision becomes noticeably blurry or distorted, or when the hole continues to enlarge, surgery is usually the best option. Acting sooner rather than later improves the likelihood of a full recovery.
The standard treatment for a macular hole is a vitrectomy, a surgery in which the vitreous gel inside your eye is gently removed to relieve the pulling or traction that caused the hole to form. Once the gel is removed, a small gas bubble is placed inside the eye to press against the macula and support healing as the hole closes. Over the next several days to weeks, the bubble is absorbed and is replaced by the eye’s natural fluids.
What to Expect Before, During, and After Surgery
Before your procedure, your retina specialist will perform a retinal exam and order advanced imaging tests, typically an OCT scan, to measure the size and depth of the hole. You’ll also review your family and medical history, as well as any medications you are taking. Your doctor will explain how to prepare for your procedure, including when to stop eating or drinking, which medications you might need to stop taking, and arranging a ride home, since you won’t be able to drive afterwards.
During surgery, most patients are awake but comfortable, as your eye will be fully numbed, ensuring you do not feel any pain or discomfort. The entire procedure typically takes less than an hour.
After surgery, you will need to keep your head in a face-down position for several days or weeks to keep the gas bubble in place. You will also be given eye drops to help lower the risk of infection and inflammation.
Follow-up visits are an important part of your recovery. During these visits, your retina specialist will monitor how the hole is healing, check the pressure inside your eye, and ensure that your vision continues to improve as expected. Vision typically improves within 4–6 weeks, with about 90% of patients experiencing successful closure of the macular hole after surgery. While full recovery can take several months, most patients notice steady progress and are able to return to many of their normal activities once the bubble fully dissolves.
Protect Your Vision with Expert Care
If you’ve noticed blurriness, distortion, or a dark spot in your central vision, don’t ignore the signs. Early evaluation by a retina specialist can make all the difference in protecting your sight.
At Palmetto Retina Center, our board-certified retina specialists use advanced imaging and surgical techniques to diagnose and treat macular holes with precision and care. From your first consultation through every follow-up visit, our team is committed to guiding you toward a safe recovery and sharper, more confident vision.
Schedule an appointment today to learn more about your treatment options and take the first step toward clearer sight.