The macula is located in the center of the eye’s light-sensitive tissue, the retina. The macula provides the best central vision needed for reading and fine detail. When scar tissue forms over the macula, causing the macula to wrinkle, it is called a macular pucker.
Scar tissue can develop in the macula due to the degeneration of the gel inside the eye (vitreous). The degeneration of the vitreous causes it to thicken and pull away from the retina, leaving damage to the retina’s surface. As the retina naturally heals itself, scar tissue is formed on the surface of the retina, attaching itself to the retina. As scar tissue contracts, the retina can wrinkle and this can cause blurred and distorted vision. Other causes of scar tissue include injury to the eye, torn or detached retina, inflammation of the eye, retinal blood vessel disorders and severe eye injury.
Vision loss and distorted vision are symptoms of a macular pucker, with great difficulty in seeing fine detail and reading small print. A gray area in the center of vision can appear, as well as a blind spot in the visual field.
Macular puckers are usually left untreated, as the symptoms of vision distortion and blurriness are mild. In some cases, the scar tissue that caused the macular pucker separates from the retina, causing the macular pucker to clear up. Surgery is recommended, however, when vision deteriorates significantly. This surgical procedure is called a vitrectomy, were the vitreous is removed and replaced with a solution and the pucker-causing scar tissue is removed. This outpatient procedure is usually performed under local anesthesia and can improve vision. In some cases, vision cannot be restored due to cataracts, which would require cataract surgery.