The macula contains a full thickness hole which is about a quarter of a disc diameter. There may
be an operculum seen in the vitreous. Note: If the macula shows wrinkling, make sure that you
are not looking at a pseudohole which may occur in cellophane maculopathy. Examine the other
eye for similar lesion as macular hole is bilateral in about 15% of cases.
- when examine the other eye look specifically for the presence of posterior vitreous
detachment (in the absence of macular hole, the presence of total posterior vitreous
detachment means that the risk of future macular hole is low)
- perform a Watzke test. A thin long beam of light is projected through a 78 or 90D
onto the macular hole and the patient is asked if there is a gap in the light. The presence
of a gap is termed positive Watzke's test and occurs in full thickness macular hole.
1. What are the causes of macular hole?