Macular Pucker

Macular pucker is an eye condition determined by the formation of scar tissue on the macula of the eye (the area located in the center of the light-sensitive tissue of the eye called the retina). The macula is responsible for the clear and central vision we need to read, drive and see in detail. A macular pucker can, therefore, cause a blurred and distorted central vision.

What Causes a Macular Pucker

The macular pucker is caused by alterations of the vitreous, a transparent gelatinous substance that fills about 80% of the inside of the eye and helps it to keep the shape round. The vitreous is placed behind the crystalline lens and in front of the retina, to which it normally adheres to.

As it ages, the vitreous is subject to liquefaction and degeneration phenomena that culminate with its separation from the retina. This phenomenon is called vitreous detachment and is physiologically normal in people over the age of 50. In most cases, there are no negative effects, except for a slight increase in floaters, small “flying flies” or grains that appear to float in the visual field.

Sometimes, however, when the vitreous body moves away from the retina, surface damage occurs. When this happens, the retina spontaneously begins a healing process in the damaged area, forming scar tissue or an epiretinal membrane on its surface. This scar tissue is firmly attached to the surface of the retina and when it contracts, it causes the retina to wrinkle, usually without any effect on central vision. However, if scar tissue is formed on the macula, sharp, central vision becomes blurred and distorted.

Other causes that can trigger the disease are certain diseases and serious eye disorders such as retinal detachment, inflammation (uveitis), diabetic retinopathy. Even the trauma caused by surgery or an eye injury can cause the pucker.

What Are the Symptoms of a Macular Pucker

Loss of vision due to a macular pucker is generally mild and moderate, a loss of sight is fortunately not common. People with macular puckers can report blurred or slightly distorted vision; straight lines may appear wavy and may have difficulty seeing details and reading smaller characters. Finally, they can complain of a gray area in the center of the visual field or even a blind spot.

How to Treat a Macular Pucker

In the case of pucker, when the vitreous exerts dangerous tractions on the retina and the visual deficit becomes marked, it is necessary to intervene surgically with a procedure called vitrectomy. This intervention involves the partial or complete removal of the vitreous and, depending on the surgical purpose, can be associated with other procedures.

Minimally invasive vitreoretinal surgery leads to an improvement in vision even if the functional result depends largely on the involvement of the retina (intensity and duration of its suffering) and can be slow or incomplete.

In the Blue Eye Ocular Microsurgery Center, macular pucker removal operations are performed under local anesthesia. The surgery, in Day Surgery, lasts about 30 minutes and is practically painless.