Macular Pucker

The macula normally lies flat against the back of eye, like film lining the back of a camera. When wrinkles, creases or bulges form on the macula, this is known as macular pucker. 

Your ophthalmologist users tiny instruments to remove the wrinkled tissued on the macula.

Symptoms of macular pucker range from mild to severe and may involve one or both eyes.

Symptoms may include:

• blurred central (detail) vision;
• distorted, or “wavy,” vision;
• difficulty reading or performing tasks that require detail vision;
• gray and/or cloudy area in central vision;
• central blind spot.

Peripheral (side) vision is not affected.

As you age, the vitreous—the clear, gel-like substance that fills the middle of your eye—begins to shrink and pull away from the retina. As the vitreous pulls away, scar tissue may develop on the macula. Sometimes the scar tissue can warp and contract, causing the retina to wrinkle or bulge. 

Eye conditions associated include:

• vitreous detachment;
• torn or detached retina;
• a inflammation inside the eye;
• a severe trauma to the eye (from surgery or injury);
• disorders of the blood vessels in the retina.

Your ophthalmologist (Eye M.D.) detects macular pucker by examining your retina. He or she may perform fluorescein angiography or optical coherence tomography (OCT) procedures that take special photographs of the eye. These photographs show if an abnormality exists in your retina. 

For mild symptoms, no treatment may be necessary. Updating your eyeglass prescription or wearing bifocals may improve vision. Eyedrops, medicines or laser surgery do not improve vision. 

For more severe symptoms, a surgery called vitrectomy is recommended. The surgery is usually performed as an outpatient procedure in an operating room. During surgery, your ophthalmologist uses tiny instruments to remove the wrinkled tissue. After the tissue is gone, the macula flattens and vision slowly improves, though it usually does not return all the way to normal. 

You should consider surgery if your blurred vision is interfering with your daily activities. 

As with any surgical procedure, rare complications can occur, including, but not limited to:

• a infection;
• a bleeding;
• a retinal detachment;
• a recurrence.

After surgery, cataracts (clouding of the eye’s lens) may also develop sooner. Be sure to discuss potential complications with your ophthalmologist before surgery.