Macular hole can appear suddenly or progressively. It affects the central vision, which may initially display deformities and, as it enlarges, it may give rise to a central black spot that prevents us from focusing our eyesight.

• Age is the most predominant risk factor, which is associated with deterioration of the vitreous gel and vitreoretinal interface. It tends to be more frequent in people over 60 years of age.
• Long-term ocular inflammatory process
• High myopia
• Macular oedema
• Retinal detachment
• Ocular trauma

The treatment is surgical and the technique used is pars plana vitrectomy, which eliminates the traction that has produced the macular hole. Peeling of the internal limiting membrane is also recommended, as well as more complex techniques such as the creation of an inverted flap to cover the hole. In more complex cases, plasma enriched in platelets and growth factors can be used, which is obtained from the patient’s own blood. Subsequently, a gas is inoculated to tamponade the macular area, which helps the hole to close anatomically during the postoperative period.

This surgery requires that, in the postoperative period, the patient’s head faces the ground, so that the gas bubble remains under the hole. This position is maintained for 45 minutes, every hour, repeating the process throughout the day. This is done for a week or for the time indicated by the ophthalmologist. At night the patient is allowed to sleep on his or her side.

During the postoperative period, for as long as the gas is present, it is forbidden to fly or even travel to the mountains, as to prevent an increase in intraocular pressure (IOP), which would lead to the irreversible loss of vision of the patient. After a certain period of time (generally between 3-4 weeks), the gas is spontaneously reabsorbed.