2020–2021 BCSC Basic and Clinical Science Course™
12 Retina and Vitreous
Part II: Disorders of the Retina and Vitreous
Chapter 18: Posterior Segment Manifestations of Trauma
Blunt Trauma Without Break in Eye Wall
Posttraumatic Macular Hole
Blunt trauma may cause a full-thickness macular hole by various mechanisms, including contusion necrosis and vitreous traction. Holes may be observed immediately after blunt trauma that causes severe commotio retinae, following a submacular hemorrhage caused by a choroidal rupture (Fig 18-4), or after a whiplash separation of the vitreous from the retina. In addition, central depressions, or macular pits (similar to those observed in patients after sun gazing), have been described following blunt trauma to the eye and whiplash injuries. Lightning and electrical injury can also cause macular holes; patients with these injuries usually have signs of cataract and can have acute peripapillary retinal whitening. Posttraumatic macular holes may close spontaneously or may be successfully closed surgically. Depending on the degree of collateral damage to the fovea, visual acuity recovery varies greatly.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.