Persistent airbag-associated scotoma is rarely described in the literature. We are aware of 2 other case reports of a persistent paracentral scotoma following airbag trauma. In one, the scotoma was attributed to a break in the Bruch membrane,1 while the other demonstrated focal thinning of the juxtafoveal neurosensory retina but had normal findings on multifocal electroretinography.2 In contrast, our case exhibited clear electrophysiological dysfunction on multifocal electroretinography, an outcome consistent with findings that central electroretinal activity remained depressed 6 months following acute traumatic maculopathy despite resolved OCT abnormalities.3 While no specific architectural disruption accounted for this patient's functional impairment, it is notable that the pattern of retinal injury suggested on fundus autofluorescence 3 days after the motor vehicle crash corresponded closely with the diminished signal distribution on multifocal electroretinography a year later. While the sudden shock on impact may have caused the photoreceptor injury described, the presence of subfoveal fluid with visual nadir 3 days after impact cannot be discounted. Serous retinopathy is a rare finding associated with trauma and may arise from localized concussive damage with retinal dehiscence on impact.4 Initially diffuse intraretinal edema has been shown to progress to outer retinal disruption.5 Alternatively, in the context of posterior vitreous detachment, tractional or concussive forces may have led to a fluid collection with impending macular hole, independently contributing to our patient's vision loss. Yamashita et al6 propose 2 mechanisms of traumatic macular hole formation: (1) immediate vision loss from primary foveal dehiscence due to concussive forces, and (2) delayed vision loss from continued vitreomacular traction. Both mechanisms may have been present in our patient. In this case, serial imaging provided insight into the evolution of traumatic maculopathy and pathogenesis of traumatic macular hole formation. Further advanced imaging may improve our ability to prognosticate and intervene following ocular trauma.