What is the macula?
The macula is the special area at the center of the retina which is responsible for clear, detailed, vision. The retina is the light-sensing layer of tissue that lines the back of the eye. If your macula is damaged, your sight will be blurred.
What is a macular pucker?
The macula normally lies flat against the back of the eye, like film lining the back of a camera. If a macular pucker is present, it means the macula has become wrinkled.
This condition is also known as cellophane maculopathy, pre-macular fibrosis, or epiretinal membrane.
What are the symptoms of macular pucker?
Vision becomes blurred and distorted, just as one would expect a picture to appear from a camera with wrinkled film. Straight lines like doorways or telephone poles often appear wavy.
Vision loss can vary from barely noticeable to severe. One or both eyes may be involved. For most people, after the initial visual loss, vision remains stable and does not progressively worsen.
What causes a macular pucker?
For various reasons, a thin transparent membrane grows over the macula. When the membrane stops growing, it contracts and shrinks, wrinkling the macula.
Eye conditions that may be associated with macular pucker include:
- vitreous detachment (aging of the gel inside the eye);
- torn or detached retina;
- inflammation inside the eye;
- severe injury to the eye;
- retinal blood-vessel disorders.
Macular pucker is not usually related to any medical problem outside the eye.
How is a macular pucker detected?
Your ophthalmologist can detect a macular pucker by examining your retina. A photographic test called a fluorescein angiogram may be done to determine the extent of damage to the macula.
Does a macular pucker need to be treated?
Treatment is not necessary if your symptoms are mild. Eyedrops, medicines, and laser surgery do not improve vision. Strengthening your bifocals or using a magnifier may improve your near vision if both eyes are involved.
Vitrectomy surgery is the only treatment than can remove a macular pucker. During this outpatient procedure, your ophthalmologist uses tiny instruments to remove the membrane which is wrinkling the macula.
After surgery, the macula usually flattens out and symptoms should slowly improve. Vision does not usually return all the way to normal. However, as many as 70% of patients can receive a two-line or greater improvement in vision. Cataracts (clouding of the eye’s lens) may develop sooner.
Complications are uncommon, but may include:
- retinal detachment;
- recurrence of macular pucker.
Surgery is not necessary for everyone who has a macular pucker. Many people who have mildly blurred vision are not bothered enough to need surgery. You should consider surgery if your blurred vision is interfering with your daily activities.