Patient Presentation: A 23-year-old obese female was diagnosed with idiopathic intracranial hypertension (IIH) and referred to neurosurgery for ventriculoperitoneal shunt. A baseline ocular examination was performed prior to the procedure.

On examination, vision was 20/200 in the right eye, and 20/40 in the left eye. There was a right relative afferent pupillary defect. Slit lamp examination was normal.

A dilated fundus examination was performed demonstrating the following:

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Retina

Case 18

Patient Presentation: A 64-year-old male with a previous history of cataract surgery presented to ophthalmology with a 3 month history of metamorphopsia in his right eye. On examination, his vision was 20/20 in both eyes. Slit lamp examination and fundus examination appeared normal. An OCT macula was performed on his right eye demonstrating the following:

Question: What is the diagnosis?

B. Lamellar Hole

C. Macular Hole

D. Cystoid Macular Edema

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Question: How do you differentiate a macular pseudohole from a macular hole and a lamellar hole?

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Learning Objectives:

1. To differentiate macular pseudohole from a lamellar hole and a full thickness macular hole

2. To identify the OCT features of a macular pseudohole, which have a vertical profile that does not involve the full thickness of the retina