The retina is the light-sensing tissue that’s located at the back of the eye. It takes focused incoming light and converts it into an electrical signal that it sends to the brain via the optic nerve, which resides right behind it.
The central 2% of the retina has a very dense cluster of nerve cells, and it’s these cells that register information coming from your high-resolution central vision. This region is called the macula, and damage to the tissue can cause serious deficits in vision.
The expert team of ophthalmologists at Retina Specialists diagnoses and treats all forms of retinal disease. However, while many patients are familiar to some extent with macular degeneration, they’re not knowledgeable about other macular problems, such as macular puckers and macular holes. The team, therefore, is taking this opportunity to enlighten you about these important conditions.
A macular pucker, also called epiretinal membrane (ERM) or cellophane maculopathy, occurs when part of your retina wrinkles, bulges, or warps due to scar tissue, which can lead to blurry vision.
Macular puckers often develop when the viscous vitreous gel that fills most of your eye and helps it hold its shape starts to shrink as part of the aging process. They may also result from eye trauma or recent eye surgery.
Sometimes the separation of the retina from the vitreous damages the retina's surface. The retina tries to heal itself, which leads to the formation of scar tissue. As the scar tissue contracts with retinal movement, it creates a puckered area.
Normally, this small scarred area doesn't cause problems, but if it forms over the macula, it affects your central vision, causing blurriness and distortions. Straight lines may appear wavy, and it may become harder to see small details. The macula has to lie flat against the back of the eye to work properly.
Recent studies suggest that 18.8%-34.1% of Americans have a macular pucker, and the risk increases with age. Fortunately, most people don’t develop poor vision as a result.
Macular holes develop for the same reason as macular puckers, but the damage here is worse. Instead of just having damage on the surface of the macula, a macular hole punches all the way through the tissue.
Macular holes cause the same types of blurriness or wavy lines as a pucker, but a hole is more likely to create a blind spot in your central vision, as well.
As we’ve mentioned, aging, with the shrinking vitreous that comes with it, is the most common risk factor for macular pucker. People with other eye problems may also get a macular pucker. These problems include:
If you notice any sudden change in your vision, make an urgent appointment with Retina Specialists to follow up and make sure you don’t lose your sight.
How your doctor treats the problem depends on your symptoms.
If you just have some mild blurriness, you might not need any treatment. Instead, your ophthalmologist may give you a new eyeglass or contact lens prescription. Of course, glasses won’t fix the macular pucker or its effects, but a new prescription can optimize and improve your remaining vision overall.
If your symptoms are more serious, the doctor may recommend a surgical procedure called vitrectomy with membrane peeling. They remove some of the vitreous and the scar tissue on your macula, which flattens it and restores it to its proper position. Then, they insert a saltwater solution into the eye to maintain its shape and function.
While your sight may never be as good as before the pucker happened, it’s likely your vision will improve after the procedure.
A vitrectomy can also treat a macular hole. The doctor removes the vitreous and injects a bubble made from air and gas into the eye to maintain its shape.
If you experience a sudden change in your vision, don’t wait. Contact Retina Specialists as soon as possible by calling us at any of our five Texas locations (Dallas, DeSoto, Plano, Mesquite, and Waxahachie) for an urgent appointment. It just may save your sight.
