A macular hole is a hole in the center part of the retina, your macula. The macula is responsible for your central and fine detail (reading) vision. Macular holes are more common in women than men, however the causation for this is unknown. Macular holes are diagnosed in stages from 0 to 4.
Macular holes typically occur as part of the natural aging process, when the vitreous (gel that fills most of the eye) thins and separates from the macula. This can pull the macula and cause a hole to form. Less commonly, holes are caused by injury to the eye, intraocular inflammation, or other diseases. Most instances of macular holes are in people over the age of 50.
Initially you may notice a small blurry or distorted area in the center of your vision. As this hole grows over weeks or months, your central vision gradually declines. A macular hole does not affect peripheral (side) vision..
Vitrectomy surgery is the best way to treat a macular hole where the vitreous is removed and a gas bubble is placed into the eye to help the hole close.
Sources: American Academy of Ophthalmology, National Eye Institute, Medline, and Krames