Case of the day

[Maria Znamenska]

Hello dear eye care specialists!

Female, 68 years old


BCVA OD = 0.3
OS = 0.8


Complaints about a decrease in visual acuity and metamorphopsia in the right eye


What type of hole is this? Full-thickness or lamellar? Treatment strategy?

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[drk]

These are fun.

I was going to say "no hole" until the last two rasters, and then saw the mini-lamellar hole.

Since ocriplasmin has lost its favor, there isn't anything to do in this case, I don't believe. The vitreo-macular traction will have to release itself, and hopefully the fovea will self-heal.

There isn't a posterior vitreous detachment and the pars plana vitrectomy would be pretty involved, but you could do it. At 20/60 acuity with metamorphopsia (which seems like worse visual acuity than I would expect from the appearance) it's an option. I would recommend observation if the patient can cope.