This 31YO male was hit in his right eye by a paintball when he was 12 years old. His vision was 20/200 due to a large, chronic 1100-micron full-thickness macular hole.
Optos imaging shows chorioretinal scarring with intraretinal pigment migration extending from the distal macula into the temporal periphery, underlying the likely impact site.
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 sudden vitreous separation or stretching of the posterior pole resulting from anteroposterior ocular compression. The holes can spontaneously close.
Unfortunately for our patient, the hole remained open, and at this point, we saw little possible surgical benefit given its chronicity, size, and secondary pigmentary changes.
