Spontaneous closure of a macular hole secondary to an accidental laser injury

Editor,—Early surgical intervention has been reported to achieve closure of laser induced macular holes.1 2 We report a case of spontaneous closure of a laser induced macular hole indicating that surgery should not be undertaken before a reasonable period of observation. ### CASE REPORT A 24 year old physics postgraduate student accidentally sustained an injury to his right eye while aligning an 806 nm titanium-sapphire laser. The laser parameters were pulse energy 2 mJ, pulse duration 100 femtoseconds, and repetition rate 10 Hz. The duration of exposure was limited by his blink reflex. He noted immediate impairment of central vision in this eye. When examined by an ophthalmologist 2 days later, visual acuity was 6/18 in the right eye. Amsler testing demonstrated an absolute paracentral scotoma which was 1.5° in diameter and abutted fixation. A full thickness macular hole was present with loss of both neurosensory retina and retinal pigment epithelium (RPE). The hole was …