The affect of a macular hole could be likened to the effect of stretching the film in a camera. Firstly, the quality of the image is very poor. Secondly, straight lines such as window frames, lampposts, or lines of print, tend to become distorted, with a bowed appearance. Thirdly, it is not unusual for patients to develop a central missing patch in their vision. In these circumstances, they frequently find that the letter in the middle of the word that they are trying to read is missing.

Macular holes tend to affect one eye at a time. Many people with a macular hole are however very aware that the poorer eye interferes with, or "gets in the way" of the better eye. As a result, even though the hole only affects one eye, the vision with both eyes open can be very unsettled. Some people go as far as covering, or closing one eye, in order to get over this effect.