Living with Macular Pucker

Macular Pucker is a condition of the eye in which a tiny "pucker" or "wrinkle" appears in the "macula" or central part of the retina at the back of the eye, often causing blurring or distortion of central vision.

What Causes Macular Pucker?

Several things can cause Macular Pucker. Sometimes diabetes or a sudden traumatic injury to the eye may be the culprit.

Most often, however, most experts believe Macular Pucker is caused simply by aging. According to the National Eye Institute, the eye is filled with a gel-like substance called "vitreous". As we age, the vitreous can shrink and pull away from the "retina", the light sensitive membrane across the back of the eye. The "macula" is the small, central part of the retina where nerve cells are closest together and where the eye focuses the images that we see. If the vitreous pulls away enough from the macula, it can cause microscopic injury that, once healed, may scar. These scars create the "puckers" or "wrinkles" known as "Macular Pucker".

How Might Macular Pucker Effect My Vision?

Often times people will have a Macular Pucker or Macular Wrinkle without even noticing it. In many cases, the pucker is so small it has no impact on vision whatsoever.

In other cases, the slight distortion of vision from Macular Pucker in one eye may cause your unaffected eye to work harder to compensate. While you still may not realize your vision is not up to par, you may begin to experience eye strain, headaches or deteriorating vision in one or both eyes over time.

If the Macular Pucker or wrinkle is large enough, you may become aware of wavy, distorted or broken vision, particularly up close or when looking at detail.

How Is Macular Pucker Diagnosed?

Your eye doctor may perform a number of different tests on your eyes to determine if you have Macular Pucker. He will be able to look with a special instrument directly at the macula at the back of your eye and may be able to see the pucker or wrinkle. Other tests may include a vision test in which you will be asked to look with each eye at a "graph" or lined picture. If the lines in some part of the graph, usually the center, appear to you to be wavy or broken, you may have Macular Pucker.

Can Macular Pucker Cause Me to Lose My Sight Entirely?

Unlike Macular Degeneration, Macular Pucker is not generally considered degenerative (progressively worsening). Vision impairment may, on rare occasions, worsen over time, but usually only from additional macular injury. In most cases, then, Macular Pucker should not result in blindness.

Can Macular Pucker Be Prevented?

There is no known way to prevent Macular Pucker. It is generally considered a condition that comes with aging or sudden traumatic injury to the eye. Good ocular nutrition may help but no specific nutrients have been identified for the prevention or treatment of Macular Pucker to date.

Can Macular Pucker Be Treated or Cured?

In many cases, your doctor may not recommend any treatment for Macular Pucker, but will, rather, want to monitor the condition.

In other cases, surgery may be warranted. Surgery for Macular Pucker is almost always successful in that the "pucker" or "wrinkle" can be flattened and vision greatly improved or, in some cases, totally corrected.

What is the Surgery Like for Macular Pucker?

According to the Cleveland Clinic, surgery for Macular Pucker is done in an outpatient facility under general anesthesia.

Starting with a "vitrectomy", the vitreous gel is removed and replaced with a salt solution. Then the pucker or wrinkle is removed. Patients are generally able to return home the same day.

Sources:

National Eye Institute: http://www.nei.nih.gov/health/pucker/pucker.asp#a

Cleveland Clinic: http://my.clevelandclinic.org/disorders/macular_pucker/hic_macular_pucker.aspx#

The Macula Center: http://www.maculacenter.com/eyeconditions/macularPucker.htm