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Macular Pucker

What is a macular pucker?
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.

Macular pucker is also known as epiretinal membrane, preretinal membrane, cellophane maculopathy, retina wrinkle, surface wrinkling retinopathy, premacular fibrosis, and internal limiting membrane disease.
Frequently Asked Questions about Macular Pucker
Is a macular pucker the same as age-related macular degeneration?
No. A macular pucker and age-related macular degeneration are two separate and distinct conditions, although the symptoms for each are similar. An eye care professional will know the difference.

Can macular pucker get worse?
For most people, vision remains stable and does not get progressively worse. Usually macular pucker affects one eye, although it may affect the other eye later.

Is a macular pucker similar to a macular hole?
Although both have similar symptoms – distorted and blurred vision – macular pucker and a macular hole are different conditions. They both result from tugging on the retina from a shrinking vitreous. When the vitreous separates from the retina, usually as part of the aging process, it can cause microscopic damage to the retina. As the retina heals itself, the resulting scar tissue can cause a macular pucker. Rarely, a macular pucker will develop into a macular hole. An eye care professional can readily tell the difference between macular pucker and macular hole.
What causes a macular pucker?
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. This is called a vitreous detachment, and 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 (Note: This is not a macular hole). When this happens, the retina begins a healing process to the damaged area and forms scar tissue, or an epiretinal membrane, 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.

Information provided by the National Eye Institute