Macular Pucker

Macular pucker is scarring on the macula of your eye. The macula is the part of the eye that lets you see clearly and sharply. It also lets you see detail. The macula is in the middle of the thin membrane that covers the back of your eye (retina). A macular pucker can affect your vision.

This condition usually starts in one eye but can affect both eyes over time. Vision changes can range from mild to severe. Vision changes usually do not get worse over time.

What are the causes?

This condition is caused by shrinking of the gel-like fluid that fills your eye (vitreous). The vitreous may shrink as you get older. As it shrinks, it pulls on your macula and forms scar tissue.

What increases the risk?

This condition is most common in people age 60 and older. Certain medical conditions can also increase your risk of macular pucker. These include:

• A disease of the retina (retinopathy).
• Injury or trauma to the eye.
• Nearsightedness (myopia).
• Tearing or detachment of the retina.
• Inflammation of the eye (uveitis).
• Diabetes.

What are the signs or symptoms?

Symptoms of this condition can vary. Symptoms depend on the severity of your condition. A mild pucker may cause no symptoms. Symptoms of this condition include:

• Blurred vision. You may have trouble reading small print or seeing fine details.
• Distorted vision. Straight lines may appear wavy.
• A gray area or blind spot in the center of your vision.

How is this diagnosed?

This condition is diagnosed based on your medical history and a physical exam. You may be referred to a health care provider who specializes in eye conditions (ophthalmologist) for an eye exam. You may also have tests, including:

• Having the back of your eye checked with a microscope.
• Having dye injected into the back of your eye before an examination.
• Having pictures of the back of your eye taken.

How is this treated?

You may not need treatment unless your symptoms interfere with your daily activities. Your eye care provider may change your eyeglass prescription if you wear glasses.

Surgery is the only treatment for macular pucker. This surgery (vitrectomy) is done only when macular pucker causes vision changes that interfere with your daily activities. In this procedure, a surgeon removes any scar tissue and replaces your vitreous with a salt–water solution.

Follow these instructions at home:

• Watch your vision for any changes.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

You have any new or worsening vision changes.