The macula is the special area at the center of the retina which is responsible for clear, detailed vision.  The retina is the light sensing layer of tissue that lines the back of the eye.  If your macula is damaged, your sight will be blurred.

What is macular pucker?

The macula normally lies flat against the back of the eye, like film lining the back of a camera.  If macular pucker is present, the macula becomes wrinkled.

This condition is also known as cellophane maculopathy, or premacular fibrosis.

What are the symptoms of macular pucker?

Vision becomes blurred and distorted, just as one would expect a picture to appear from a camera with wrinkled film.  Straight lines, like doorways or telephone poles, often appear wavy.

Vision loss can vary from barely noticeable to severe.  One or both eyes may be involved.  For most people, vision remains stable and does not get progressively worse.

What causes macular pucker?

A thin, transparent membrane grows over the macula.  When the membrane stops growing, it contracts and shrinks, wrinkling the macula.  Eye conditions that may be associated with macular pucker include:

• vitreous detachment (aging of gel inside eye)
• torn or detached retina
• inflammation inside eye
• severe injury to eye
• retinal blood vessel disorders

Macular pucker is not usually related to any medical problem outside the eye.

How is it detected?

Your ophthalmologist can detect macular pucker by examining your retina.  A photographic test called fluorescein angiogram may done in order to tell the extent of damage to the macula.

Does macular pucker need to be treated?

Treatment is not necessary if your symptoms are mild.  Eyedrops, medicines, or laser surgery do not improve vision.  Strengthening your bifocals or using a magnifier may improve near vision if both eyes are involved.

Vitrectomy surgery is the only treatment that can remove macular pucker.  During this outpatient procedure your ophthalmologist uses tiny instruments to remove the membrane which is wrinkling the macula.

Usually, the macula flattens out and the symptoms slowly improve.  Vision does not usually return all the way to normal.  Cataracts (clouding of the eye's lens) may develop sooner.

Complications are uncommon, but may include:

• infection
• bleeding
• retinal detachment
• re-occurrence of macular pucker

Surgery is not necessary for everyone who has macular pucker.  Many people who have mildly blurred vision are not bothered enough to need surgery.  You should consider surgery if your blurred vision is interfering with your daily activities.

©The American Academy of Ophthalmology