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Epiretinal Membranes (Macular Puckers)

What is a macular pucker?

The macula is the central portion of the retina responsible for seeing fine details. In order for it to function normally, it needs to be flat and smooth against the wall of the eye like film inside a camera. In some people, the delicate macula can gradually become wrinkled or creased, which is known as a macular pucker.

What causes a macular pucker?

Usually a pucker develops when a thin layer of tissue grows along the surface of the macula. As this tissue develops, it creates a wrinkling in the very delicate underlying retina. This condition is quite common, but only a fraction of macular puckers ever produce any noticeable change in the vision. Most macular puckers do not have a specific cause. Occasionally they can be seen with other conditions of the eye such as a history of torn or detached retina, eye trauma, or inflammation.

What are the symptoms of a macular pucker?

Symptoms vary between patients. Symptoms typically develop when the pucker causes significant distortion of the macula itself, resulting in blurred or distorted central vision.

How is a macular pucker treated?

It depends on the severity. Mild puckers can be safely observed and may remain stable indefinitely. For advanced or severe puckers resulting in a significant loss of vision, surgical removal of the pucker can stabilize or improve the vision. The surgery, called a intercom, involves inserting tiny instruments into the anesthetized eye to remove the vitreous gel which fills the eye. Delicate forceps are then used to peel away the membrane from the surface of the macula, which allows it to return to a more normal shape. Your doctor will discuss the severity of your condition and whether or not surgery is indicated.

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