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The macula is the small area at the center of the eye's retina that allows your to see fine details clearly. The retina is a layer of light-sensing cells linig the back of your eye.  As light rays enter yoru eye, the retina converts the rays into signals, which are sent through the optic nerve to your brain where they are recognized as images. 


Damage to your macula casues blurred central vision, making it difficult to perform tasks such as reading small print or threading a needle.  


The macula normally lies flat against the back of the eye,like a film lining that back of a camera.  When wrinkles, creases, or bulges form on the macula, this is known as macular pucker.  


Symptoms of macular pucker range from mild to severe and may involve one or both eyes.  Symptoms may include blurred central vision, distorted or wavy vision, difficulty reading, gray or cloudy areas in your central vision, and/or a central blind spot.  Peripheral vision is not affected.












As you age, the vitreous - the clear, gel-like substance that fills the middle of your eye - begins to shrink and pull away from the retina.  As the vitreous pulls away, scar tissue may develop on the macula. Sometimes the scar tissue can warp and contract, causing the retina to wrinkle or bulge. 


Eye conditions associated with macular pucker inlcude: vitreous detachement, torn or detached retina, inflammation inside the eye, severe trauma to the eye and disorders of the blood vessels in the retina. 


Your ophthalmologist detects macular pucker by examining your retina.  YOur doctor may perform fluorescein angiography or optical coherence topography (OCT) - procedures that take special photographs of the eye.  These photographs show if an abnormaiity exists in your retina. 


For mild symptoms, no treatment may be necessary.  Updating your eyeglass prescription or wearing bifocals may improve your vision.  Eyedrops, medicines or laser surgery do not improve vision.  


For more severe symptoms, a surgery called  vitrectomy is recommened.  The surgery is usually performed as an outpatient procedure in a operating room.  During surgery, your doctor uses tiny instruments to remove the wrinkled tissue on your macula.  After the tissue is gone, the macula flattens and visions slowly improves, though it usually does not return all the way to normal. 


As with any surgical procedure, complications can occur with vitrectomy surgery.  Complications may include infection, bleeding, retinal detachment, and/or recurrence of macular pucker. 


After vitrectomy surgery, cataracts may also deveop.  Be sure to discuss potential complication with your ophthalmologist before surgery. 

Macular Pucker

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