It is unusual for a macular hole to close without surgery.

Macular holes form when surface tension on the retina causes the center of the retina to pull apart.  In most cases, the surface tension will not allow the macular hole to close on its own.  Instead, a retina specialist will perform surgery to close the hole.  The procedure consists of a vitrectomy (removing the vitreous from the eye), peeling of the elastic membrane on the surface of the retina (Internal Limiting Membrane), and closure of the hole using the surface tension of a gas bubble.  Patients may have to position themselves face down for a short period of time after a macular hole repair.