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.