Macular Pucker

What is a Macular Pucker?

The macula is the centermost portion of the retina, located in the back of your eye. It is responsible for sharp, detailed vision. Normally, the macula lies flat, like the film in the back of a camera. Sometimes a thin scar tissue forms over the macula, causing it to become wrinkled or “puckered.”

What Causes a Macular Pucker?

A thin, transparent sheet of scar-like tissue migrates across the surface of the macula, where it clings onto the delicate tissues. Eventually, it begins to shrink and create wrinkling of the macula. Eye conditions that may be associated with the development of a macular pucker include:

  • Posterior vitreous detachment (aging and separation of the gel inside the eye)
  • Torn or detached retina
  • Inflammation inside eye
  • Severe injury to eye
  • Retinal blood vessel disorders

A macular pucker is not usually related to any medical problem outside the eye.

How is it Detected?

Your ophthalmologist can detect a macular pucker by examining your retina. Various photographic tests are used to determine the extent of damage to the macula. These include fluorescein angiography and OCT.

How is a Macular Pucker Treated?

Eye drops, medicines, and lasers have no effect on this condition. For people who have only mildly blurred vision and are not bothered by it, no treatment is necessary. However, for those whose vision is more significantly affected, microsurgery called a vitrectomy is the only treatment that can remove a macular pucker. During this outpatient procedure, your doctor uses tiny instruments to remove the scar-tissue that is wrinkling the macula.

Will my Vision Improve With Surgery?

Typically, patients can expect improvement on the eye chart. This often takes months. As the macula flattens out, the symptoms of waviness and blur slowly improve, although the vision does not always return completely to normal. Patients with a cataract (clouding of the natural lens in the eye) that is present before a vitrectomy will often have progression of the cataract over time. Your doctor will inform you when it is time to see your general eye doctor to update your glasses prescription or be considered for cataract surgery evaluation.

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