A macular hole, also known as a macular cyst, is a small hole formed in the macula due to tension on the surface of the retina due to shrinking vitreous. With age, the structures of the eye change. This is true of the gel-like fluid vitreous, which fills the area between the lens and the retina. Over time, its composition changes; its fibers begin to clump together and shrink away from the retina. This is a natural occurrence and usually has no negative effects. Occasionally though, in areas where it is firmly adhered to the retina, it will pull the retina with it.
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