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» Retina Services - Macular Pucker The macula is in the center of the retina, the light-sensitive layer of tissue at the back of the eye. As you read, light is focused onto your macula. There, millions of cells change the light into nerve signals that tell the brain what you are seeing. This is called your central vision. With it, you are able to read, drive, and perform other activities that require fine, sharp, straight-ahead vision.
What is a macular pucker? Macular pucker, also known as epiretinal membrane is a condition that affects the macula and distorts the central vision. An abnormal layer of scar tissue appears on the macula and can progress to shrink and wrinkle the underlying retina. When that happens, the central vision will become distorted and all straight lines will appear crocked. In advanced conditions the vision will decrease because of swelling in the retina caused by the wrinkling effect of the scar tissue.
What causes this condition and can it be prevented? In the majority of cases of epiretinal membrane no specific cause can be identified. A history of previous surgery or laser treatment on the eye, trauma, inflammation or vascular condition can be related to the formation of this scar tissue. There is no means known to prevent epiretinal membrane from forming. What is the treatment for this condition? In most cases the
distortion in vision is minimal and does not affect
the day-to-day activities like driving, reading or
watching television. When the macular pucker is severe
enough to drop vision or distort the view in a way
interfering with life style and daily activity,
treatment is indicated. How fast does the vision come back after having surgery? It takes several weeks for the retina to assume its normal original shape. Some improvement is usually noticed within 4-6 weeks after surgery. This usually manifests in straightening of lines and decreased distortion. Improvement on the vision chart may take longer to happen. Is there any medication (drops) or nutritional supplement that can treat or "dissolve" this scar tissue? Unfortunately, there is no known medication or nutritional supplements that can be given to treat epiretinal membrane. Surgical treatment is the only treatment available for this condition. How long do I have to be in the hospital for this surgery and what kind of restrictions should I expect? In most cases, the surgery will be a "same day surgery". This means that patients will be discharged home few hours after surgery. Occasionally, patients are kept overnight for observation. There are very few restrictions after surgery. Bending down and lifting objects heavier than 10 lbs are discouraged. Are macular holes and macular degeneration related to macular pucker? Macular degeneration is not related to macular pucker except that they both can cause distortion in central vision. The distortion caused by macular degeneration is typically permanent and cannot be treated by surgery. Macular hole is a true full-thickness defect in the macula that result from side traction on the center of the retina. In certain cases, traction from the epiretinal membrane may result in a formation of a macular hole. If I don't have surgery for macular pucker, will I continue to lose vision until I'm blind? Typically, patients with macular pucker will experience deterioration in vision over few weeks or months but then stabilize and not progress further. It is advised to seek treatment when vision has dropped to the degree that it interferes with daily activity like reading and driving and not wait for vision to deteriorate further especially that the likelihood of that happening is small. It has to be emphasized that mild epiretinal membranes with no vision loss do not require treatment.
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