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What is a Macular Pucker?

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  • Written By: Tricia Ellis-Christensen
  • Edited By: O. Wallace
  • Last Modified Date: 30 August 2016
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In the human eye, the macula is the very center of the retina and helps people to see most when performing tasks like reading. Sometimes, a condition called macular puckering or macular pucker can occur, which can mildly to severely distort the eye’s focused and central vision. The macula essentially becomes wrinkled and forms scar tissue, which is usually not associated with any form of eye injury. Instead it may be caused by things like the vitreous fluid (eye jelly) pulling away from the retina, as it often does with aging, though a clear cause isn’t always identifiable.

Macular pucker may or may not greatly distort vision and there are usually three grades of this condition. Minor puckering may be known as surface wrinkling. When this is present, people might not be aware of the condition, since it usually only occurs in one eye, until they see an eye doctor. Cellophane maculopathy is the name given to a more moderate form of macular pucker, when vision may be noticeably affected, and the most severe form of this condition is called a full macular pucker. Here vision distortions can be much greater and render it difficult for people to see many things clearly.

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The many cases of macular pucker in all of its forms suggest it is not always necessary to treat the condition. Slight deterioration of vision in one eye may remain slight. In other words, macular pucker rarely gets worse, and many people determine that they can quite easily cope with a barely perceptible decrease in sight. Using things like bright lights or magnifiers to read or do fine work could be the only adaptation required.

However, when the condition presents as cellophane maculopathy or full macular pucker, distortions in vision might be more difficult to bear. This really depends on the individual’s perception of how sight has changed and whether they sense they can live with any changes. In these cases more aggressive treatment might be considered.

The principal way to treat cellophane maculopathy or full macular pucker is to perform eye surgery. This is done under anesthesia and the wrinkled or scar tissue area is removed. Provided additional scar tissue doesn’t develop, this can fix the problem. Rate of success may vary among surgeons but overall success rate, when scarring is simply peeled off is between 70-90% or better. Interviewing surgeons and asking them about individual success rates and experience with this procedure may be advisable given success rate range.

This condition, even when most severe, has a good chance of treatment with surgery. Many people who have only mild changes may not require surgery. Likelihood of puckering becoming more severe is minimal, but people should report any noted changes in vision to their ophthalmologist.

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