The condition where a hole (break) develops in the most sensitive part of the retina, i.e. the macula, is called macular hole. Most macular hole developed spontaneously in the fifth decade of life and the early symptoms are increasing distortion in vision (straight lines are seen as wavy) and poor straight ahead (central) vision causing difficulty in reading small prints.

Females in the menopausal age group are more often affected, and as high as 10% of patients may have similar condition, although not to the same degree, in the fellow eye. If early macular hole is neglected, the central vision will gradually worsen and soon the patient will be unable to read.
Some forms of macular holes are related to blunt trauma to the eye, retinal detachment and prolonged swelling of the macular region. However, most cases of spontaneously developed macular hole can be attributed to contraction of a fine layer of scar that forms over the macular region of the eye (see anatomy). This fine layer of scar is also termed epiretinal membrane.

Macular hole can be closed with surgery (see services). Modern surgery to close macular hole is very effective and should be performed ideally within a year of the development of such hole.