The eye is filled with vitreous, a gel-like substance that helps the eye maintain its shape. As people age, the vitreous begins to shrink and pull away from the retina. This is usually not an issue. In rare cases, some resilient fibres refuse to let go of the retina (about three per 1,000 people over the age of 60). The vitreous body shrinks while the stubborn fibres cling to the retina, resulting in a tug-of-war. This tug of war can result in a hole in the retina's clearest central vision area, the macula. The body's defences against scar tissue are activated when a hole forms in the retina. The hole and scar tissue cause blurriness and visual distortion. A macular hole is distinct from macular degeneration or retinal detachment.
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