A macular pucker is scar tissue that has formed on the eye’s macula, located in the center of the light-sensitive tissue called the retina. The macula provides the sharp, central vision we need for reading, driving, and seeing fine detail. A macular pucker can cause blurred and distorted central vision.
Most of the eye’s interior is filled with vitreous, a gel-like substance that fills about 80 percent of the eye and helps it maintain a round shape. The vitreous contains millions of fine fibers that are attached to the surface of the retina. As we age, the vitreous slowly shrinks and pulls away from the retinal surface, which is normal. In most cases, there are no adverse effects, except for a small increase in floaters, which are little “cobwebs” or specks that seem to float about in your field of vision.
However, sometimes when the vitreous pulls away from the retina, there is microscopic damage to the retina’s surface. When this happens, the retina begins a healing process to the damaged area and forms scar tissue on the surface of the retina. This scar tissue is firmly attached to the retina surface. When the scar tissue contracts, it causes the retina to wrinkle, or pucker, usually without any effect on central vision. However, if the scar tissue has formed over the macula, our sharp, central vision becomes blurred and distorted.
What is the treatment?
A macular pucker usually requires no treatment. In many cases, the symptoms of vision distortion and blurriness are mild, and no treatment is necessary. People usually adjust to the mild visual distortion, since it does not affect activities of daily life, such as reading and driving. Sometimes the scar tissue–which causes a macular pucker–separates from the retina, and the macular pucker clears up on its own.
Rarely, vision deteriorates to the point where it affects daily routine activities. However, when this happens, surgery may be recommended.