A macular hole is a defect in the center of the retina called the fovea. The hole forms from traction on the retina and is similar to a button hole. Macular holes cause vision loss, with a central blind spot. Over time, the vision will worsen without surgery. Surgery consists of a vitrectomy and gas bubble with or without peeling of the internal limiting membrane (a thin layer on the surface of the retina). Most patients position face down for 5 days after surgery. While it is not an emergency, surgical outcomes are better if the macular hole is repaired quickly (within 6 months) then if repair is delayed.