Macular pucker is a condition where the macula becomes wrinkled and forms scar tissue, causing distorted vision. It can be caused by aging and vitreous fluid moving away from the retina. Surgery is the primary treatment for more severe cases, with a success rate of 70-90%. Mild cases may not require treatment.
In the human eye, the macula is the very center of the retina and helps people see more when performing tasks such as reading. Sometimes, a condition called macular wrinkling or macular pucker can occur, which can mildly or severely distort the eye’s focused, central vision. The macula essentially becomes wrinkled and forms scar tissue, which is usually not associated with any form of eye injury. Instead it can be caused by things like vitreous fluid (eye jelly) moving away from the retina, as often happens with aging, although a clear cause isn’t always identifiable.
Macular pucker may or may not greatly distort vision, and there are usually three degrees of this condition. Small wrinkles can be known as surface wrinkles. When this is present, people may not be aware of the condition, as it usually only occurs in one eye, until they see an eye doctor. Cellophane maculopathy is the name given to a more moderate form of macular pucker, when vision can be markedly impaired, and the more severe form of this condition is called complete macular pucker. Here vision distortions can be much greater and make it difficult for people to see many things clearly.
The many cases of macular pucker in all its forms suggest that it is not always necessary to treat the condition. Slight vision impairment in one eye may remain mild. In other words, macular pucker rarely gets worse, and many people determine that they can easily cope with a barely noticeable decrease in vision. Using things like bright lights or magnifying glasses to read or do good work may be the only adaptation required.
However, when the condition presents as cellophane maculopathy or full macular pucker, vision distortions may be more difficult to bear. This really depends on the individual’s perception of how vision has changed and whether they feel they can live with any changes. In these cases, more aggressive treatment may be considered.
The primary way to treat cellophane maculopathy or complete macular pucker is to perform eye surgery. This is done under anesthesia and the wrinkled or scar tissue area is removed. Provided no further scar tissue develops, this can solve the problem. The success rate can vary between surgeons, but the overall success rate, when the scar is simply removed, is between 70-90% or higher. Interviewing surgeons and asking them about individual success rates and experience with this procedure may be advisable given the range of success rates.
This condition, even when it’s more serious, has a good chance of being treated with surgery. Many people who have only minor changes may not require surgery. The likelihood of wrinkles becoming more severe is minimal, but people should report any noted changes in vision to their ophthalmologist.
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