Macular Pucker

globe anatomy

anatomy of the eye (click on image to enlarge)

What is the Macula?

The macula is a special area of the retina that gives you fine, central, reading vision. The retina is a thin layer of tissue that lines the back of the eye. It acts like the film in a camera. The retina “takes a picture” of objects you look at and sends it to the brain.

What is Macular Pucker?

Macular pucker occurs when abnormal scar tissue grows like a sheet of cellophane on the macula and causes wrinkling. Macular pucker is present in about one in twenty eyes and is more common later in life. It may occur from aging of the gel inside the eye (vitreous separation), from a torn or detached retina, or from inflammation. Macular pucker is not the same problem as macular degeneration. Macular pucker does not lead to macular degeneration

What are the Symptoms?

The presence and severity of symptoms vary widely with macular pucker. Symptoms include distortion and blurred vision. Distortion means that straight lines look crooked or wavy. Some patients have few or no symptoms and the macular pucker remains stable without worsening.

What is the Treatment?

If symptoms are mild and well-tolerated, no treatment is needed. The macular pucker may not progress and the vision may not worsen further. New glasses will not restore the vision to normal. There is no role for vitamins, exercises, eye drops, pills, or laser in the treatment of macular pucker. This problem usually affects one eye, although occasionally both eyes are involved. When the symptoms of macular pucker interfere with daily activities, vitrectomy surgery can improve vision by removing the abnormal tissue that wrinkles the retina. The amount of visual improvement depends upon the health of the retina under the scar tissue. Usually, there is a significant improvement in vision with much less distortion. Rarely, does the vision return completely to normal. Improvement in vision after surgery takes month to years.

Below is a time-lapse video of a retina scan (OCT) of a 64 year-old woman with longstanding blurred vision and distortion in her right eye with 20/100 vision. After surgery her thickened retina gradually thinned (although it did not return to normal). Her vision returned to 20/25 over time.

For more information please visit Retina Vitreous Associates of Florida.

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