Macular Pucker: Symptoms, Diagnosis and Treatment
A macular pucker is a retinal condition that can cause blurry, wavy or distorted central vision. It develops when a thin layer of tissue forms over the macula and contracts, causing the normally smooth retinal surface to wrinkle or “pucker.”
Macular pucker is also known as an epiretinal membrane (ERM). Mild cases may only require monitoring, while moderate or severe cases can be treated with surgery to remove the membrane and relieve its pull on the retina.
If you notice new distortion or changes in your central vision, schedule an evaluation with a retina specialist at Meadows Eye Physicians & Surgeons.
What Is a Macular Pucker?
The retina is a light-sensitive layer of tissue located at the back of the eye. At its center is the macula, the area responsible for sharp, detailed central vision. You depend on your macula when reading, driving, recognizing faces and seeing fine details.
A macular pucker develops when a thin, transparent membrane forms over the macula. As the membrane contracts, it pulls on the retinal tissue underneath it. This disrupts the normal architecture of the macula and may cause the tissue to wrinkle.
The amount of visual change depends on the thickness of the membrane and how strongly it affects the macula. Some people have very mild symptoms, while others experience significant distortion that interferes with everyday activities.
Macular Pucker Symptoms
Macular pucker usually affects central vision rather than peripheral, or side, vision. Symptoms may include:
- Blurry central vision
- Straight lines appearing bent, wavy or distorted
- Difficulty reading small print
- Trouble recognizing faces
- Objects appearing different in size between the two eyes
- A gray, cloudy or blank area in the center of vision
- Difficulty performing detailed tasks
- Reduced vision in the affected eye
Visual distortion caused by a macular pucker is called metamorphopsia. For example, lines on a doorframe, window blind or sheet of graph paper may appear curved when viewed with the affected eye.
Symptoms can range from mild to extremely debilitating. Macular pucker generally does not cause complete blindness, but advanced cases can significantly reduce useful central vision.
What Causes a Macular Pucker?
Most macular puckers occur as part of the natural aging process.
The inside of the eye is filled with a clear, gel-like substance called the vitreous. As a person ages, the vitreous gradually changes and pulls away from the retina. This is known as a posterior vitreous detachment, or PVD.
During this process, cells may collect on the surface of the retina and form a thin membrane. The membrane may remain stable, or it may contract and begin pulling on the macula.
Macular pucker can also develop in younger patients, particularly when there is a history of:
- Eye trauma
- Inflammation inside the eye
- Retinal tears or retinal detachment
- Previous retinal surgery
- Retinal blood-vessel disease
- Diabetic retinopathy
- Other conditions affecting the retina
In many cases, no specific cause other than normal age-related changes can be identified.
Macular Pucker Treatment in Las Vegas
The retina specialists at Meadows Eye Physicians & Surgeons diagnose and manage macular pucker throughout the Las Vegas area. Using detailed retinal examinations and OCT imaging, our physicians can determine how severely the membrane is affecting your macula and whether observation or surgery is appropriate.
If blurry or distorted vision is interfering with your daily activities, an evaluation can help identify the cause and determine the best next step.
Call Meadows Eye Physicians & Surgeons at (702) 358-0472 to schedule a retinal evaluation.