This 13YO girl was hit in her right eye while playing volleyball. She presented to us several months later with 20/200 vision, an inferotemporal macular scar from resolved commotio retina, and a full-thickness macular hole.
The macular hole was closed following successful vitrectomy, and she was 20/100 one month postoperatively. Vision improved to 20/40 three months following surgery. Since the scotoma from the macular scar was superior, she is now virtually completely visually asymptomatic and extremely lucky!
Learning Points:
Traumatic macular holes are more common in younger patients, often from recreational or sports injury, and tend to be more eccentric in shape.
The mechanism could be due to sudden vitreous separation or to stretching of the posterior pole resulting from anteroposterior ocular compression. The holes can spontaneously close and have a high surgical success rate, as in our patient (see Liu et al AJO 2020;210:174-183).
