Most macular holes (72%) are caused by trauma associated with a wide range of causes.
Less common causes:
(1) X-linked retinoschisis (XLRS)
(2) high myopia
(3) incontinentia pigmenti
(4) optic pit
(5) ocular toxocariasis
(6) retinopathy of prematurity
Trauma may also be associated with retinal detachment, a macular lesion, peripheral retinal tear, cataract, vitreous hemorrhage, submacular hemorrhage, endophthalmitis or other lesion.
The extent of the hole can be studied using optic coherence tomography.
Closure of the macular hole was associated with better visual acuity. Following trauma a small macular hole was more likely to close spontaneously. If spontaneous closure does not occur then surgery may be needed to close the hole.
The presence of a macular lesion (commotio retina, other) is associated with worse final visual acuity.
