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Interesting Cases

Macular hole

·         This 64 yr old female presented on 23rd Dec 2010, with a  full thickness macular hole in right eye and BCVA of 6/18, N36. She was advised vitrectomy for the same, however she refused surgery at that time.

·         She came for follow up 8 months later in Aug 2011. At that time the BCVA in RE dropped to 6/36p, N36 and hole had increased in size.

·         On 6th September 2011 she underwent vitrectomy with sf6 gas injection and was advised prone position for 3 days as per routine postoperative instructions.

·         However when she came for follow up 6 days later on 12th September, the hole had opposed, but was not completely closed. She was advised strict position for 22 hours, and the next day the hole had opposed much more. This position was continued for 3 more days, and on 16th September 2011, the hole was completely closed anatomically.

·          At her last follow up visit on 4th october 2011, the BCVA in right eye had improved to 6/12, N18.

·          This case highlights the importance of strict position, post vitreoretinal surgeries. In most patients, macular hole closes in 3 days, however in this patient it took longer probably because of the chronicity of the condition. However maintaining strict prone position helped in closure of the full thickness macular hole.