Narciso F. Atienza, Jr. MD, MBA, DPBO
EYE PHYSICIAN AND SURGEON
DIPLOMATE, PHILIPPINE BOARD OF OPHTHALMOLOGY
SUBSPECIALTY IN DISEASES AND SURGERY OF THE RETINA, VITREOUS, AND MACULA and OCULAR ONCOLOGY
DIPLOMATE, PHILIPPINE BOARD OF OPHTHALMOLOGY
SUBSPECIALTY IN DISEASES AND SURGERY OF THE RETINA, VITREOUS, AND MACULA and OCULAR ONCOLOGY
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, premacular fibrosus, or epiretinal membrane.
What are the symptoms of macular pucker?
Vision becomes blurred or distorted, just as one would expect a picture to appear from a camera with wrinkled film. Straight likes, like doorways or telephone poles, often appear wavy.
Vision loss can vary from hardly 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 syneresis and separation (aging of the gel inside the eye)
• Torn or detached retina or vitreous
• Surgery inside the eye
• Inflammation inside the eye
• Severe injury to the eye
• Retinal blood vessel disorders
Macular puckers are usually not related to any medical problems outside the eye.
What testing might be done?
Your ophthalmologists can diagnose a macular pucker by looking inside your eye with special instruments. A photographic test called fluorescein angiogram and another test called an OCT (optical coherence tomogram) may be done in order to determine the extent of the 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 puckers. Your regular ophthalmologist will refer you to a retina surgeon ((an ophthalmologist who has undergone at least one year in clinical fellowship in retinal surgery, and is practicing fulltime in this subspecialty) to manage your macular pucker. Usually, the retina surgeon will either recommend observation, if the macular pucker is not causing problems, or surgery if your vision has gone worse and is severely distorted, and if he believes that it will help your vision to improve.
During vitrectomy surgery, the retina surgeon will use very delicate and fine instruments inside the eye to remove the vitreous gel and membrane which is wrinkling and pulling on the macula.
After the surgery, the macula flattens out and the symptoms slowly improve. Vision does not usually return all the way to normal.
Visual recovery is dependent on some of the factors enumerated: 1) How long the membrane has been present, 2) Etiology of the membrane, 3) Experience of the surgeon doing the surgery, 4) Whether you have had your cataracts removed before or not. If you haven’t had cataract surgery, it is likely that you will have it earlier. Cataract surgery ALONE will probably not cause any remarkable improvement in your central vision.
Complications are uncommon, but may happen, and this include
• Accelerated cataract formation
• Bleeding
• Infection
• Retinal detachment
• Re-occurrence of the 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.
Why are regular medical eye examinations important for everyone?
Eye diseases can strike at any age. Many eye diseases do not cause symptoms until the disease has done damage. Since most blindness is preventable if diagnosed and treated early, regular medical examinations by an ophthalmologist are very important.
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, premacular fibrosus, or epiretinal membrane.
What are the symptoms of macular pucker?
Vision becomes blurred or distorted, just as one would expect a picture to appear from a camera with wrinkled film. Straight likes, like doorways or telephone poles, often appear wavy.
Vision loss can vary from hardly 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 syneresis and separation (aging of the gel inside the eye)
• Torn or detached retina or vitreous
• Surgery inside the eye
• Inflammation inside the eye
• Severe injury to the eye
• Retinal blood vessel disorders
Macular puckers are usually not related to any medical problems outside the eye.
What testing might be done?
Your ophthalmologists can diagnose a macular pucker by looking inside your eye with special instruments. A photographic test called fluorescein angiogram and another test called an OCT (optical coherence tomogram) may be done in order to determine the extent of the 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 puckers. Your regular ophthalmologist will refer you to a retina surgeon ((an ophthalmologist who has undergone at least one year in clinical fellowship in retinal surgery, and is practicing fulltime in this subspecialty) to manage your macular pucker. Usually, the retina surgeon will either recommend observation, if the macular pucker is not causing problems, or surgery if your vision has gone worse and is severely distorted, and if he believes that it will help your vision to improve.
During vitrectomy surgery, the retina surgeon will use very delicate and fine instruments inside the eye to remove the vitreous gel and membrane which is wrinkling and pulling on the macula.
After the surgery, the macula flattens out and the symptoms slowly improve. Vision does not usually return all the way to normal.
Visual recovery is dependent on some of the factors enumerated: 1) How long the membrane has been present, 2) Etiology of the membrane, 3) Experience of the surgeon doing the surgery, 4) Whether you have had your cataracts removed before or not. If you haven’t had cataract surgery, it is likely that you will have it earlier. Cataract surgery ALONE will probably not cause any remarkable improvement in your central vision.
Complications are uncommon, but may happen, and this include
• Accelerated cataract formation
• Bleeding
• Infection
• Retinal detachment
• Re-occurrence of the 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.
Why are regular medical eye examinations important for everyone?
Eye diseases can strike at any age. Many eye diseases do not cause symptoms until the disease has done damage. Since most blindness is preventable if diagnosed and treated early, regular medical examinations by an ophthalmologist are very important.
