Macular Pucker (Epiretinal Membrane)

RCA & the AAO Present Retina Macular Pucker Vitrectomy

The macula is the small area at the center of the eye’s retina that allows you to read and see fine details clearly. The macula normally lies flat against the wall of the eye, like wallpaper on a wall. A macular pucker occurs when a membrane, like cellophane, covers the surface of the macula. Often, these membranes remain completely flat and do not cause vision problems. However, sometimes the membrane contracts on the surface of the retina, causing it to wrinkle or pucker.


Symptoms of a macular pucker range from mild to severe and may involve one or both eyes. These symptoms include blurry central vision, distorted or wavy vision (straight lines seem crooked or bent), difficulty reading, or gray spot in central vision.


Macular puckers are associated with several eye conditions. The most common cause is due to a posterior vitreous separation in which the vitreous gel that fills the eye pulls away from the retina, leading to scar tissue on the macula. Macular puckers can also develop following a torn or detached retina, uveitis (inflammation inside the eye), diabetic retinopathy, or trauma. A macular pucker is diagnosed by your eye doctor and can be further evaluated with special tests like optical coherence tomography (OCT) or fluorescein angiography.


For mild symptoms, no treatment may be necessary. Changing your eyeglasses prescription may improve vision. For more severe symptoms, vitrectomy surgery can be performed as an outpatient procedure in an operating room. During surgery, the vitreous gel that fills the eye is removed and replaced with a clear fluid. Tiny instruments are used to gently remove the membrane off the retina’s surface. After the tissue is gone, the macula usually flattens and vision slowly improves, though it usually does not return all the way to normal.

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