MACULAR PUCKER
Q&A D.M. DEUPREE, MD
A different condition from Age-
Related Macular Degeneration
(AMD), Macular Puckers have
similar symptoms.
WHAT IS MACULAR PUCKER OR EPIRETINAL
MEMBRANE?
A macular pucker is scar tissue that
has formed on the eye’s macula,
located in the center of the eye’s
light-sensitive tissue called the retina.
The macula provides the sharp,
central vision we need for reading,
driving, and seeing fine detail. A
macular pucker can cause blurred
and distorted central vision.
Most of the eye’s interior is filled
with vitreous, a gel-like substance
that helps it maintain a round shape.
The vitreous contains millions of fine
fibers that are attached to the retina.
As we age, the vitreous slowly shrinks
and pulls away from the retina’s surface.
This is called a vitreous detachment,
and is normal. In most cases,
there are no adverse effects, except for
a small increase in floaters, which are
little “cobwebs” or specks that float
about in your field of vision.
Sometimes when the vitreous pulls
away from the retina, there is a small
amount of damage to the retina’s
surface. As the retina heals itself, scar
tissue forms on the surface of the
retina. When this scar tissue contracts,
it causes the retina to wrinkle,
or pucker, usually without any effect
on central vision. However, if the scar
tissue forms over the macula, vision
becomes blurry and distorted.
Most macular puckers are related to
vitreous detachment, which usually
occurs in people over age 50. Certain
eye diseases and disorders can trigger
a macular pucker, such as a detached
retina and inflammation of the eye
(uveitis). Also, people with diabetes
sometimes develop an eye disease
called diabetic retinopathy, which
can cause a macular pucker. Trauma
from either surgery or an eye injury
can also cause a macular pucker.
WHAT ARE THE SYMPTOMS?
Vision loss from a macular pucker
can vary from no loss to severe loss,
although severe vision loss is uncommon.
People with a macular pucker
may notice that their vision is blurry
or mildly distorted, and straight lines
can appear wavy. They may have difficulty
in seeing fine detail and reading
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