Macular Hole and Macular Pucker
The macula is the center region of the retina, and its health is required for sharp central vision. If there is a defect in all layers of the retina within the macula, this is referred to as a macular hole.
Most macular holes develop spontaneously without clear cause, though some may be related to trauma, prior swelling or inflammation of the retina.
They are diagnosed with a dilated eye exam and non-invasive imaging called optical coherence tomography.
The most common and most effective treatment for macular holes is a surgical procedure called vitrectomy.
A macular pucker is a membrane that grows along the surface of the retina and can cause varying degrees of distortion of the central vision. It is also commonly referred to as epiretinal membrane, cellophane maculopathy, or a wrinkle on the retina.
They most commonly form as a result of an aging process of the eye that causes the internal gel to liquefy and separate from the surface of the retina. Some cases may be related to prior trauma, inflammation in the eye, diseases of the retinal blood vessels, or prior eye surgery. They are often found incidentally on routine eye exams.
A non-invasive imaging test called optical coherence tomography is helpful for diagnosis and to monitor for change over time.
Most macular puckers are mild, cause minimal symptoms, and do not require treatment. However, they can progress over time and some result in significant blurring or distortion of the central vision. These cases can be treated with surgical removal called vitrectomy with membrane peel.