Macular pucker

By Medically reviewed by hellodoktor

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What is macular pucker?

A macular pucker is a condition that occurs when scar tissue that has formed on the eye’s macula, located in the center of the light-sensitive tissue called the retina. The macula plays an essential role in the sharp, central vision we need for reading, driving, and seeing fine detail. A macular pucker can cause blurred and distorted central vision.

There are number of names for macular pucker such as epiretinal membrane, preretinal membrane, cellophane maculopathy, retina wrinkle, surface wrinkling retinopathy, premacular fibrosis, and internal limiting membrane disease.

How common is macular pucker?

Macular puckers are related to aging and usually occur in people over age 60. It is a painless condition which can happen without warning. Please discuss with your doctor for further information.


What are the symptoms of macular pucker?

The common symptoms of macular pucker are:

  • Vision loss
  • Blurry ormildly distorded vision
  • Wavy lines
  • Difficulties reading smallfine
  • Gray area in the center of your vision
  • Blind spot

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consulting with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.


What causes macular pucker?

Most of our eyes’ interior is filled with vitreous, a gel-like substance that fills about 80 percent of the eye and enables it maintain a round shape. The vitreous contains millions of fine fibers are attached to the surface of the retina. When we age, the vitreous slowly shrinks and pulls away from the retinal surface, called a vitreous detachment, and it is normal. In most cases, there are no adverse effects, except for a small increase in floaters, which are little “cobwebs” or specks that seem to float about in your field of vision.

However, sometimes when the vitreous pulls away from the retina, there is microscopic damage to the retina’s surface. When this happens, the retina begins a healing process to the damaged area and forms scar tissue, or an epiretinal membrane, on the surface of the retina. This scar tissue is firmly attached to the retina surface. When the scar tissue contracts, it causes the retina to wrinkle or pucker usually without any effect on central vision. However, if the scar tissue has formed over the macula, our sharp, central vision becomes blurred and distorted.

Risk factors

What increases my risk for macular pucker?

There are many risk factors for macular pucker, such as:

  • Female gender
  • Old age
  • A history of eye disorders, such as high myopia (nearsightedness), injury to the eye, retinal detachment

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is macular pucker diagnosed?

If your doctor suspects that you may experience this condition, a physical examination will be performed and some tests will be also recommended by your doctor. During an eye exam, your doctor will dilate your pupils and examine your retina. You may have a test called fluorescein angiography that uses dye to illuminate areas of the retina.

Another test called optical coherence tomography (OCT) is helpful in making an accurate macular pucker diagnosis. With OCT, a special camera is used to scan your retina. It measures the thickness of the retina and is also very sensitive at detecting swelling and fluid.

OCT can also diagnose macular abnormalities that are too small to be seen in an examination or with angiography.

How is macular pucker treated?

Actually, a macular pucker usually requires no treatment. In many cases, the symptoms of vision distortion and blurriness are mild, and no treatment, therefore, is necessary. People usually adjust to the mild visual distortion, since it does not affect activities of daily life, such as reading and driving.

It is noticed that neither eye drops, medications, nor nutritional supplements will improve vision distorted from macular pucker. Sometimes the scar tissue, which causes a macular pucker, separates from the retina, and the macular pucker clears up.

Rarely, vision deteriorates to the point where it affects daily routine activities. However, when this happens, surgery may be recommended. This procedure is called a vitrectomy, in which the vitreous gel is removed to prevent it from pulling on the retina and replaced with a salt solution (Because the vitreous is mostly water, you will notice no change between the salt solution and the normal vitreous). Also, the scar tissue which causes the wrinkling is removed. A vitrectomy is usually performed under local anesthesia.

After the operation, you will need to wear an eye patch for a few days or weeks to protect the eye. You will also need to use medicated eye drops to protect against infection.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage macular pucker?

The following lifestyles and home remedies might help you cope with macular pucker:

  • Wearing protective eyewear when playing sports or using tools
  • If you are diabetic, control your blood sugar and see your doctor regularly.
  • Get regularly eye exams, especially if you have risks for macular pucker.

It is essential to know the symptoms of macular pucker. Recognizing when you may have an eye problem and seeking medical care immediately can save your vision.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.


Review Date: August 22, 2017 | Last Modified: September 12, 2019

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