The macular hole occurs when a tear or opening forms in the macula, located near the center of the retina, that is responsible for sharp, clear, straight-ahead vision. Aging is the most common cause of the macular hole. Vitrectomy is the best method to treat a macular hole. Ophthalmologists start by removing the vitreous that is pulling on your macula. Then a gas bubble is put inside your eye; this bubble helps flatten the macular hole and holds it in place while your eye heals. The gas bubble then slowly goes away on its own.