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Macular Pucker

Macular pucker is caused by scar tissue that develops in the macula, which is the very center of the retina that provides focused vision. Like a macular hole, macular pucker occurs more frequently as we age, when the vitreous gel within the back portion of the eye begins to shrink. Sometimes the shrinkage pulls on the retina and stimulates the formation of scar tissue, which results in macular pucker. This in turn causes blurry or distorted vision. A macular pucker usually does not worsen and may occur only in one eye.

Virginia Mason ophthalmologists have broad experience diagnosing and treating patients with retinal disorders, including macular pucker. Find more information or schedule an appointment with a Virginia Mason Franicscan Health ophthalmologist in Seattle, Federal Way, Issaquah, Kirkland or Lynnwood.

  • Blurry and wavy or distorted vision are the most common signs of macular pucker. These signs result when the vitreous gel separates from the retina and stimulates the formation of scar tissue in the region of the macula, resulting in macular pucker.

  • Your eye doctor will first have you undergo a visual acuity test to examine your distance vision. Your eyes will then be dilated so that he or she can examine the internal structure of your eyes, including the retina. If macular pucker is suspected, you may have additional diagnostic testing, which enhances the image of your retina. This information will be used to evaluate the degree of macular pucker and to monitor the response to treatment, should treatment be required.

  • For most patients, macular pucker is not treated because the distortion of vision is not severe enough to interfere with everyday activities, such as driving and reading. A minority of patients may have surgery to remove the vitreous gel (vitrectomy) and scar tissue (membrane peeling) so that it no longer distorts the macula.

    • During surgery—your ophthalmologist will replace the vitreous gel with a saline solution. This is then replaced by the eye with aqueous humor, a naturally produced fluid.
    • Following surgery—at home, you will be asked to wear an eye patch for one or more days and to use prescription eyedrops that help the healing process. You will be scheduled for follow-up visits over the next several weeks.

    The majority of patients who have surgery for a macular pucker will experience an improvement in visual function. The visual distortion vision is typically significantly reduced. Your ophthalmologist will talk with you about the amount of vision you can expect to regain following treatment.