In eyes with lamellar macular holes, what clinical or OCT features push you toward recommending surgery versus continued observation?

In eyes with lamellar macular holes, under what circumstances do you consider surgery rather than continued observation?

• Progressive visual decline even without major OCT changes
• Structural progression on OCT
• Disruption of outer retinal layer
• Presence of epiretinal proliferation or tractional membranes
• I almost always observe unless progression to full-thickness macular hole occurs
• Other