C55327: Macular holes – and can they be caused by a minor fall?

A seven-year-old girl slips in the bathroom, and breaks her leg (fracture in femur). A six-year-old boy while playing, jumps from a stool, and fractures his leg. A 52-year-old businessman falls down from the upper berth while travelling in a train, but is unhurt. And, a 65-year-old housewife falls from her bed while sleeping, and is apparently unhurt; let us call her Mrs Grewal.

Sensing something wrong with her progressive-power spectacles, Mrs Grewal goes for an eye examination. She is a hypermetropic astigmatic presbyope, and is not satisfied with improvement in vision with glasses in her right eye.

In this article I will first consider the nature of macular holes. I will then review their assessment and management. Then we will return to the case of Mrs Grewal.