Which slit-lamp observation suggests a macular hole?

Which slit-lamp observation suggests a macular hole?

• A. A thin line of light is projected over the macula
• B. A line appearing broken when a light is projected over the macula
• C. A dark spot on the macula
• D. Bright glare at the peripheral retina

Answer: (B)

A macular hole alters the way light reflects from the fovea during slit-lamp illumination. When you shine a narrow slit across the macula, a healthy retina produces a continuous, uninterrupted line of light. A full-thickness macular hole disrupts this reflex, so the projected line in the macular region appears broken or interrupted. This broken-line sign is a classic clue for a macular hole (and is related to the practical idea behind the Watzke-Allen test). The other observed patterns aren’t specific to a hole: a continuous line over the macula doesn’t indicate a hole, a dark spot could be a variety of macular changes, and bright glare at the peripheral retina points to areas outside the macula.

A macular hole alters the way light reflects from the fovea during slit-lamp illumination. When you shine a narrow slit across the macula, a healthy retina produces a continuous, uninterrupted line of light. A full-thickness macular hole disrupts this reflex, so the projected line in the macular region appears broken or interrupted. This broken-line sign is a classic clue for a macular hole (and is related to the practical idea behind the Watzke-Allen test). The other observed patterns aren’t specific to a hole: a continuous line over the macula doesn’t indicate a hole, a dark spot could be a variety of macular changes, and bright glare at the peripheral retina points to areas outside the macula.