Traumatic Macular Hole

Traumatic macular holesTraumatic macular hole (TMH) are seen most commonly following blunt ocular traumaBlunt ocular trauma. The majority of TMHs develop immediately after trauma due to vitreous traction on the fovea associated with a rapid trampoline effect inflicted upon the globe or due to overstretching of the more elastic foveal area. Foveal microstructural OCT biomarkers and concomitant ocular pathologies secondary to trauma are significant riders that could affect the final visual outcome. Spontaneous closure of TMH is relatively more common compared to primary FTMH and warrants observation and monitoring of its development in selected cases. The size of the hole is an important factor in determining the optimal therapeutic intervention. Small TMHs ≤ 300 µm can close spontaneously, while larger holes require surgery. Pars plana vitrectomyPars plana vitrectomy (PPV) and classic internal limiting membrane (ILM) peelInternal Limiting Membrane (ILM) peeling could suffice in surgically naïve TMHs whose minimum linear diameter (MLD) is ≤ 500 µm. TMHs with larger MLD and recurrent cases require alternative surgical maneuvers.