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Macular Pucker

The macula is the central part of the retina, and it is responsible for detailed vision such as reading. A macular pucker is a thin, transparent scar tissue which grows over the macula. This thin sheet can contract and form wrinkles in the retina and distort vision. This condition is also known as epiretinal membrane, cellophane maculopathy, and premacular fibrosis.

Symptoms

Symptoms of macular pucker include blurry and distorted vision in the affected eye. Straight lines such a table edges may appear curved or wavy. These symptoms may range from mild to severe, and one or both eyes may be affected.

Most typically, macular puckers occur in people over 50 years of age. However, younger people can be affected as well. There may be associated eye conditions such as:

  • torn or detached retina
  • posterior vitreous detachment (separation of the gel from the back of the eye)
  • a blocked blood vessel in the retina
  • inflammation in the eye
  • trauma to the eye

Diagnosis

Macular puckers can be detected by a complete eye exam with your ophthalmologist. As retinal specialists, our focus is to determine how much the macular pucker is contributing to your visual symptoms and what can be done to remedy the problem.Fluorescein Angiography is a test performed in the office which can help us determine the health of the macula. Optical Coherence Tomography (OCT) is a state-of-the-art test which helps us actually visualize how much the pucker is pulling on the macula.

Treatment

The only treatment is vitrectomy surgery where the thin layer of scar tissue is actually removed with tiny instruments by your retinal specialist. This is an outpatient surgery and typically takes about 45 minutes. It takes several weeks for the retina to heal and to realize the full visual benefit of the surgery. Usually there is a noticeable improvement in vision, although not all the way back to normal.

There are no drops, laser, or other treatments that will help. Glasses only help up to a point, but they do nothing for the distortion. Fortunately, most people with a macular pucker do not need surgery. Surgery should only be considered if the visual benefit is interfering with your everyday life.