Will I Get a Macular Hole in My Other Eye?
Your Risk of a Macular Hole in the Other Eye at a Glance
You have had a macular hole in one eye, and you want to know if the other eye is next. Here is the honest, calming answer. Your risk is higher than average, but it is still low for most people. If you have had a macular hole in one eye, about 1 in 10 people, or roughly 10 of every 100, will develop a macular hole in the other eye. 1 That means most people who have had a hole in one eye never get one in the second. Watching for symptoms and keeping your eye exams is the whole plan.
A macular hole is a small gap in the macula, the central part of the retina that gives you sharp, straight-ahead vision. A macular hole blurs the central vision you use for everyday tasks like reading and driving, while your side (peripheral) vision stays. 1 It is not the same as macular degeneration, and it does not cause total blindness. Knowing that difference takes some of the fear out of the question you are asking.
Use it to stay ahead of the risk, not to worry. Tell your retina doctor you are watching your second eye, learn the warning signs further down this page, and keep your scheduled exams. If a symptom ever appears, getting seen promptly gives your vision the best chance. That combination, awareness plus regular exams, is a reasonable and low-effort way to protect the eye you are worried about.
What a Macular Hole Is and How Common It Is
The change is usually gradual, not sudden. At first you might notice that straight lines look wavy or that things look distorted or blurry when you look straight ahead, and over time a dark or blank spot can appear in your central vision. 1 Because the hole affects only the center of your sight, you keep your peripheral vision, which is why a macular hole makes reading hard but does not leave you unable to get around.
To weigh your risk, start with how uncommon this is overall. Each year only about 8 of every 100,000 people develop a macular hole, and it is most common in women and in people in their sixties and seventies. 2 So this is not a common condition to begin with. Having had one in a first eye raises your personal odds, but it starts from a low baseline in the general population.
Most macular holes are an age-related event inside the eye, not something you did. As you age, the vitreous, the clear gel that fills the eye, shrinks and pulls away from the retina, and if it stays firmly attached to the macula it can pull hard enough to open a hole. 1 Because this pulling process happens in both eyes as you age, the same mechanism that caused the first hole is what puts the second eye at some added risk.
Why the Other Eye Can Be at Higher Risk
The added risk comes from shared biology, not bad luck alone. The vitreous ages in both eyes, so an eye that has not yet fully separated from the macula can still be under traction. Bilateral macular holes, meaning holes in both eyes, have been reported in anywhere from about 2 to 28 of every 100 patients across different studies. 2 That wide range reflects different groups and follow-up times, but the takeaway is steady: a second hole is possible, yet the majority of second eyes stay clear.
Not every second eye carries the same risk, and imaging helps sort this out. Because a macular hole forms when the aging vitreous pulls on the macula, an eye whose vitreous has already fully separated is past that main risk, while an eye where the vitreous is still attached and pulling stays at higher risk. 1 This is why your retina specialist looks closely at the other eye with a scan called optical coherence tomography, which shows whether the vitreous is still pulling.
It helps to clear up common worries. Using your eyes, reading, screen time, and ordinary daily activity do not cause a macular hole, and neither does the surgery you had on the first eye. Most holes come from the natural aging of the vitreous, which you cannot feel or control. Understanding that can ease any guilt about the first hole and refocus your energy on the part that helps: watching for symptoms and keeping your exams.
What the Research Says About the Second Eye
The research gives a reassuring shape to your question. Studies that follow patients over years find a macular hole in the second eye in only a minority of people, close to 1 in 10 by National Eye Institute figures. 1 So while a second hole can happen, the numbers describe a minority of people, and the risk is not a coin flip. It is a reason for watchfulness, not for alarm.
Timing matters to how closely you are watched. The years right after a first macular hole are generally when the fellow eye deserves the closest attention, which is why your specialist may examine it more often early on. This does not mean you can stop watching later; it means the highest-yield window for catching a change early tends to be in the years right after your first hole, so staying consistent with exams then is especially worthwhile.
A risk figure describes a group, not your future. A 1-in-10 average does not mean you are guaranteed a second hole, and it does not mean you are safe either. Your own risk depends on what the scan shows in the other eye, whether the vitreous has separated, and your overall eye health, which only an exam can assess. That is why a personalized plan from your retina specialist beats any single statistic on this page.
The Outlook If It Does Happen
Here is the part that should reassure you most. A macular hole is usually repaired with surgery called vitrectomy, in which the retina specialist removes the vitreous gel and places a gas bubble that acts like a temporary bandage to help the hole close, and this surgery closes the hole in more than 90 of every 100 cases. 3 Closing the hole does not always restore vision fully, but many people regain a meaningful amount of central sight, especially when the hole is treated early.
Speed is the part you can influence. When a macular hole is treated sooner, or when the hole is still small, the outlook for vision is better. 3 That is the real reason to know the symptoms and act on them: the same surgery tends to give a better result on a fresh, small hole than on one that has been present and growing for months.
A history in one eye is a prompt, not a sentence. Most people who have had a macular hole live normally, keep their regular eye appointments, and never have a problem in the second eye. Knowing your history simply means you and your eye doctor stay a little more watchful over the years, which is a reasonable trade for peace of mind.
Watching Your Other Eye
Simple home checks catch changes between visits. Cover your good eye and look at something with straight lines, like a door frame or a grid, one eye at a time. If the lines look wavy, or a blurry or dark spot appears in the center, that is worth reporting. Doing this quick check regularly means you are far more likely to notice a subtle change in the second eye early, when treatment tends to work best.
Home checks work alongside professional exams, not instead of them. Tell your retina specialist you are monitoring the fellow eye, and ask how often you should be seen; with a history in one eye, they often recommend regular dilated exams and periodic scans of the other eye. These visits can catch early changes, sometimes before you notice symptoms, which is exactly when acting early pays off.
When to See Your Eye Doctor
Do not wait weeks if your central vision changes in the second eye. Contact your eye doctor promptly if straight lines start to look wavy or distorted, if things look blurry when you look straight ahead, or if a dark or blank spot appears in the center of your vision. 1 These are the typical signs of a macular hole. Getting checked quickly does not just calm your worry; it puts you in the best position for an early repair if a hole is forming.
Some eye symptoms are more urgent than a macular hole and need same-day attention. Get eye care the same day, or go to an urgent eye service, if you notice a sudden shower of new floaters, flashes of light, or a dark shadow or curtain moving across your vision, because these can signal a retinal tear or detachment rather than a macular hole. Do not wait to see if they pass; caught early, a tear is often treated quickly before it threatens your sight.
A macular hole is managed by a retina specialist, an ophthalmologist with extra training in the back of the eye. They confirm the diagnosis with a scan, decide whether and when to operate, and monitor the fellow eye you are worried about. If you are ever unsure whether a symptom counts, call rather than wait: your eye team would far rather check an eye and reassure you than have you sit on a change that treatment could fix.
Common Questions About Your Other Eye
Higher than average, but still in your favor. About 1 in 10 people who have had a macular hole in one eye develop one in the other eye, which means roughly 9 of every 10 do not. Long-term studies put the fellow-eye risk at around 9 in 100 over many years. Your real number depends on what a scan shows in the other eye, so ask your retina specialist for a read on your specific risk.
There is no proven way to prevent one, because most holes come from natural aging of the vitreous inside the eye, which you cannot control. What genuinely helps is early detection: check each eye at home for wavy lines or a central blur, keep your dilated eye exams, and report any change quickly. No eye drops, supplements, exercises, or screen habits have been shown to prevent a macular hole, so do not rely on them.
Usually the surgery closes the hole. Vitrectomy closes a macular hole in more than 90 of every 100 cases, and many people regain a meaningful amount of central vision, especially when the hole is treated early and is still small. Closing the hole does not always restore perfect vision, and results differ from eye to eye, but the odds of a successful repair are good. Your retina specialist can explain what to expect for your eye.
No. The surgery on your first eye does not cause or raise the risk of a hole in the second eye. Any added risk in the fellow eye comes from the shared aging of the vitreous in both eyes, not from your treatment. What your first-eye history does mean is that your retina specialist will keep a closer watch on the second eye, which is a benefit, not a hazard.
More Questions About Macular Holes and Vision
No. A macular hole affects your central vision, the sharp sight you use for reading and faces, but it does not touch your peripheral (side) vision, so it does not cause total blindness. Even without treatment you keep your side vision, and with successful surgery many people recover useful central vision too. It is a serious change worth treating, but it is not the loss of all sight.
Promptly, but a macular hole is not usually a same-day emergency the way a retinal detachment is. If your central vision becomes wavy or blurred or you notice a central spot, contact your eye doctor within a few days rather than waiting for your next routine visit, because earlier repair tends to give better vision. If instead you get sudden floaters, flashes, or a shadow across your vision, treat that as same-day urgent, since it can signal a detachment.
No, they are different conditions that happen to affect the same area. A macular hole is a physical gap in the macula caused by the vitreous pulling on it, and it is often repairable with surgery. Macular degeneration is a gradual breakdown of macular tissue, managed differently. Both reduce central vision, which is why people confuse them, but the cause, treatment, and outlook are not the same. Your retina specialist can tell you which one you have.
- Based on my scan, what is the vitreous doing in my other eye, and what is my personal risk?
- How often should I have a dilated exam and a scan of the second eye?
- What exact symptoms should make me call you, and how fast?
- If a hole forms in the second eye, how soon would you operate?
- What vision result is realistic for me if I need surgery on the other eye?
- Is there anything in my health, like diabetes, that changes my risk?