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A 23-year-old male experienced a cricket ball injury to his right eye 1 day ago. Right eye visual acuity was counting fingers close to face. He presented with anterior uveitis, commotio retinae, and vitreous hemorrhage. Steroids and cycloplegics were given. Fundus showed resolved vitreous hemorrhage, a healthy optic disc, patchy epiretinal membrane, choroidal ruptures, peripapillary scarring, and 20/80 vision on follow-up. Patient developed a full-thickness macular hole 11 months after trauma, decreasing vision to 20/120. Exam and optical coherence tomography showed no abnormal posterior vitreous detachment. Macular hole surgery closed the hole with a normal foveal contour without improving vision. At the last follow-up 6 months after surgery, the hole was closed and vision improved to 20/120. A delayed traumatic macular hole unrelated to vitreomacular traction or cystoid macular edema deroofing has not been reported in literature. Traumatic macular hole development may be delayed by secondary epiretinal membrane contraction, ocular movements, or expansion of choroidal rupture.
Gadde et al. (Mon,) studied this question.
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