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Macular hole, epiretinal membranes and vitreomacular traction (VMT)


  • Macular holes occur in 2-3 of the general population
  • Epiretinal membranes are found in 10% of the general population
  • VMT – the incidence is unknown

A macular hole is a disorder that affects the centre of the macula (the central region of the retina). A macular hole can occur with age and is more common in women than men. It measures approximately one millimetre in diameter and occurs in the very centre of your line of vision.

How do macular holes occur?

A macular hole is caused by an abnormal attachment of the vitreous jelly to the macula. This is usually present from birth but does not become evident until separation starts later in life, from the age of approximately 40 to 60. As the vitreous jelly separates from the retina it creates a hole in the macula. This usually appears as blind spot in your vision. Symptoms might show some similarity to macular degeneration so it is worth having your ophthalmic surgeon examine you to find the correct cause of the symptoms.

Epiretinal membranes

These are more common than macular holes. In this condition, as the vitreous jelly pulls away from the retina during the process known as posterior vitreous detachment (PVD) then a fibrotic membrane grows across it. This is known as an epiretinal membrane. It is unknown as to why this occurs in some people and not others.

The membrane resembles cellophane and as it grows it can distort the retinal surfaces. With an epiretinal membrane, images appear bigger or smaller than those seen with the unaffected eye, straight lines can also be distorted.

Vitreomacular traction (VMT)

This is occurs when the vitreous jelly is mildly stuck to the macula. As the jelly pulls away during the process of posterior vitreous detachment (PVD), it separates from the retina across the entire surface except for the macula, and it remains this way.

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