What will happen if I don’t have macular hole surgery?

Typically, when a macular hole is not repaired, it can enlarge over time and pigmentary changes (a form of scarring in the retina) can occur in the macula. Also, vision continues to decline and eventually decreases to 20/400 or worse. If you have surgery for macular hole after having one for a long time, your vision usually will not improve much. So, it is typically better to repair macular holes when they happen rather than wait. When macular holes are repaired early, visual acuity (sharpness) gains can be substantial.