Macular hole caused by intense pulsed light: a case report

Intense pulsed light (IPL)-induced macular holes are rare but potentially severe. We report a case with anatomically successful surgical closure but poor functional recovery. A 30-year-old male sustained accidental ocular exposure to 808 ± 10 nm IPL without eye protection. One week later, best-corrected visual acuity (BCVA) was 20/200; optical coherence tomography (OCT) revealed a large full-thickness macular hole (basal diameter: 1639 μm) with cystoid edema and retinal pigment epithelium (RPE) disruption. Despite oral corticosteroids, the hole remained open at 1 month. Pars plana vitrectomy with internal limiting membrane peeling and sterile air tamponade achieved anatomical closure by postoperative day 7. However, BCVA remained 20/200 at 1 month due to persistent IS/OS discontinuity and RPE defects.

This case highlights that IPL can cause large, traction-associated macular holes. Even early surgical closure may not restore vision if photoreceptor and RPE integrity are compromised. Eye protection is essential during IPL handling.