Abstract
A 70-year-old man presented with gradual visual decline in both eyes; the vision had become worse in the right eye recently. On fundus examination, the right eye was found to have a large macular hole; the left eye was unremarkable. The best-corrected visual acuity was 20/100 in the right eye and 20/63 in the left eye. Optical coherence tomography confirmed the macular hole in the right eye and revealed an unsuspected foveal atrophy with interruption of outer retinal bands in the left eye, suggestive of macular phototoxicity. Based on this evaluation, leading questions were asked, whereupon he admitted to a long-time morning ritual of sun-gazing. After vitrectomy with internal limiting membrane peeling in the right eye, the macular hole closed, and the best-corrected visual acuity improved to 20/40. A full-thickness macular hole presumably secondary to sun-gazing was successfully treated with significant visual improvement.
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