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Macular Pucker

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Macular pucker (more correctly termed epimacular fibrosis) is a common but highly variable eye condition. Affected eyes may have no symptoms or functional limitation if the degree of macular distortion is minimal.

Advanced pucker complexes generate significant vision loss secondary to physical distortion (wrinkling) of the macula. Bending of normal retinal blood vessels generates leakage of fluid (edema) which further depresses macular function.

What causes Macular Fibrosis (Pucker)?

Growth and contracture of cells on the retinal surface may generate puckering of the macula.

Macular pucker can also be triggered by certain eye diseases and disorders, such as retinal tears and inflammation of the eye (uveitis). Trauma, blunt or penetrating, can also stimulate puckers.

What are the symptoms of Macular Fibrosis (Pucker)?

Symptoms from macular pucker can vary from imperceptible to severe vision loss. People with macular pucker may notice that their vision is blurry or mildly distorted with straight lines appearing wavy. They may have difficulty in seeing fine detail and reading small print. The symptoms do not vary with blinking or instillation of lubricating drops.

What is the treatment for Macular Fibrosis (Pucker)?

Macular pucker usually requires no treatment. In many cases, the symptoms of vision distortion and blurriness are mild. People usually adjust to the mild visual distortion since it does not affect activities of daily life (reading and driving). Macular pucker may spontaneously separate from the retina with posterior vitreous detachment (PVD).

Vitreous surgery may be recommended if vision is significantly limited by pucker. A vitrectomy is usually performed under local anesthesia on an outpatient basis. The probability of vision improvement with surgery is very high.

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