Macular pucker happens when wrinkles, creases or bulges form on your macula. The macula must lie flat against the back of your eye to work properly. When the macula wrinkles or bulges, your central vision is affected.
With macular pucker, things can look wavy or you may have trouble seeing details. You might notice a gray or cloudy area in your central vision. You may even have a blank spot in your central vision. Macular pucker will not affect your peripheral (side) vision.
As you age, the vitreous — the clear, gel-like substance that fills the middle of your eye — begins to shrink and pull away from the retina. As the vitreous pulls away, scar tissue may develop on the macula. Sometimes the scar tissue can warp and contract, causing the retina to wrinkle or bulge.
Other eye conditions associated with macular pucker include:
Your ophthalmologist will put drops in your eyes to dilate (widen) your pupil. This allows him or her to look through a special lens at the inside of your eye.
Then the ophthalmologist will take pictures of your eye using optical coherence tomography (OCT). With OCT, a machine scans the back of your eye. This provides very detailed images of the retina and macula. Your ophthalmologist studies these pictures to check for problems.
How you are treated depends on your symptoms.
If your symptoms are mild, you might not need any treatment. Eye drops, medicine, and laser surgery do not help vision if you have macular pucker.
If your symptoms are severe, your ophthalmologist may recommend a surgery called vitrectomy. Your ophthalmologist will remove some of the vitreous and scar tissue on your macula. This flattens the macula, returning it to its proper position. It is likely your vision will slowly improve. However, your sight may not be as good as it was before macular pucker.