The macula is the center part of the retina tissue. It is responsible for our good central vision. This is the vision we need for reading and driving. A macular pucker, also known as an epiretinal membrane, occurs when a layer of fibrous tissue forms on the surface of the macula. As the fibrous tissue (macular pucker) worsens, the vision becomes more blurry and/or distorted.
Macular puckers are more common in aging people, and typically occur following a vitreous detachment. A vitreous detachment occurs when the vitreous, a gel like substance in the eye, begins to pull away from the retina. This is a normal process that is a result of aging. A vitreous detachment can lead to damage on the surface of the retina. As the retina heals, fibrous tissue sometimes forms on the macula, and this scar tissue can “pucker.” Macular puckers can also be associated with retinal detachment, diabetic retinopathy, and eye inflammation, among other things.
Macular puckers do not always require treatment. Surgery is a common treatment of macular puckers that cause more significant vision impairment. This surgery is called a vitrectomy, in which the vitreous gel and the fibrous tissue are removed. Over time, vision usually improves, but it does not usually return to normal.