Macular Pucker

What is a macular pucker?

A macular pucker is scar tissue that has developed on the macula, the central part of the retina of the eye. It is also called premacular fibrosis, preretinal membrane, cellophane maculopathy, epiretinal membrane, retina wrinkle, internal limiting membrane disease, and surface wrinkling retinopathy. It typically affects just one eye, though the other eye may develop a macular pucker later.

What causes a macular pucker?

The vitreous is the gel-like substance that fills the eyeball. As you age, the vitreous begins to shrink and pull away from the surface of the retina, causing vitreous detachment. If this pulling away causes microscopic damage on the retina, a healing process begins that results in scar tissue. When the scar tissue contracts, it can cause the retina to pucker or wrinkle. When this wrinkling happens over the macula, it is called a macular pucker.

How would I know if I had a macular pucker?

Your macula is responsible for sharp, central vision. If you have a macular pucker, you may experience blurred and distorted vision. Straight lines may appear wavy. You may also:

  • Have trouble seeing fine detail
  • Struggle to read small print
  • See a gray area or blind spot in the center of your vision

The best way to know for sure if you have a macular pucker is to have a comprehensive dilated eye exam from an eye care professional.

Can a macular pucker be treated?

For most people, no treatment is needed. Your vision stabilizes and does not get progressively worse, and you can learn to adjust to the mild vision distortion. If the scar tissue separates from the retina, your macular pucker may actually clear up on its own.

However, if your vision gets bad enough that you have trouble accomplishing routine daily activities, you may need a surgical procedure called vitrectomy. During this operation, the ophthalmologist removes the vitreous and replaces it with saline solution, and also removes the retinal scar tissue. Your vision usually does not return to normal, but it may improve significantly after the surgery.