If untreated, there is a small chance, about 1 in 10, that some macular holes can close spontaneously, with improvement in vision. Careful examination can assess the risk of developing a macular hole in the other eye. Your surgeon will tell you your risk, but this may be from extremely unlikely to a 1 in 10 chance. It is very important to monitor for any changes in vision of the fellow eye, and report these to your eye specialist/family doctor/optician urgently.
A macular hole can often be repaired by an operation called a vitrectomy, peel & gas. If the hole has been present for less than a year, the operation will be successful in closing the hole in about 90% of cases. Of these, more than 70% will be able to see two or three more lines down a standard vision chart, compared to before the operation. Even if this degree of improvement does not occur, the vision is at least stabilised, and many patients will find that they have less distortion. In a minority of patients, who often have very large macular holes, the hole does not close despite surgery and the central vision can continue to deteriorate; however, a second operation can still be successful in closing the hole. It is important to understand that return to completely normal vision is not possible and that vision improvement depends on factors other than purely closure of the hole, particularly the condition of the light-sensing retinal cells (photoreceptors).
[British and Eire Association of Vitreoretinal Surgeons – Macular Hole, see www.beavrs.org]
