What is a macular pucker (epiretinal membrane)?
Macular pucker develops when wrinkles or creases form on the center of the retina—macula. The macula must lie flat against the back of the eye to see well. When the central retina becomes wrinkled, the central vision may become affected.
With macular pucker, things can look wavy, distorted, or blurry. You may have trouble seeing fine details. You may also notice gray or cloudy central vision. Macular pucker does not affect the peripheral vision.
What causes macular pucker?
Age is the most common cause of macular pucker. As we age, the vitreous (gel that fills the back cavity of the eye) begins to shrink and pull away from the retina. Usually the vitreous pulls away without causing problems. Occasionally, the vitreous sticks to the retina with subsequent “scar” formation, causing the retina to wrinkle or bulge.
Who is at risk for macular pucker?
Aging is the most common risk factor. Other factors may contribute to the formation of a macular pucker including:
Detached or torn retina
Swelling or bleeding inside the eye from blood vessel issues (diabetic retinopathy, vascular occlusion)
How is macular pucker diagnosed?
Your ophthalmologist will perform a medical exam of the eye following dilation. Special pictures called optical coherence tomography (OCT) will provide detailed images of the central retina. These scans allow for the visualization of a cross-section of the retina.
Macular Pucker OCT of Macular Pucker
How is macular pucker treated?
How you are treated depends on your symptoms.
If your symptoms are mild, and the pucker is not affecting the quality of the vision, you might not need any treatment at all. Eye drops, medicine, and laser do not help the vision with a macular pucker.
If your symptoms are severe, your ophthalmologist may suggest vitrectomy surgery to remove the vitreous and scar tissue from the surface of the retina. It is likely the vision would slowly improve. However, your sight may not return to the level it was prior to having a macular pucker.
What are the risks of vitrectomy surgery?
Like any surgery, vitrectomy has risks, including but not limited to:
Glaucoma (elevated eye pressure)
Click on the following link to the American Academy of Ophthalmology EyeSmart page for more information:
(*the above information was adapted from the handout "Macular Pucker, Patient Education”, provided by the American Academy of Ophthalmology)