What is Macular Pucker?

Macular pucker affects approximately 10 percent of people, particularly men and women over the age of 50. Based in the center of your retina, the macula is responsible for the part of your vision that allows you to see straight ahead. As you read the text on this page, you are using your macula. When the retinal surface forms an extra layer of tissue and contracts, distorting the retina, it is known as a macular pucker. They look like a piece of scotch tape and can distort the central vision. If you start to notice this, you should see a doctor for macular pucker as soon as possible.

What is Age-Related Macular Degeneration (AMD)?

Age-Related Macular Degeneration (AMD) is a disease, which causes visual loss in patients over the age of 50. The vision loss is painless, usually gradual and not severe, but can be variable among patients. Macular degeneration is named for the macula, the part of the retina responsible for central vision. Peripheral vision is usually not affected by macular degeneration and often, this illness will go unnoticed until a patient engages in a task such as driving or reading, in which central vision is crucial. As the term “degeneration” implies, the illness becomes more noticeable over time and tends to get worse with or without treatment. Macular degeneration typically affects adults over 65 and the main risk factors for the disease are increasing age and genetics (family history of macular degeneration). Smoking, high cholesterol and hypertension are also risk factors. This disease does not cause total blindness and most macular degeneration patients can see well enough to care for themselves.

What is Retinal Tear and Retinal Detachment?

Retinal detachment is treatable when caught early. Treatment may or may not involve an in or outpatient surgical procedure. In cases that do require surgery, a patient may require immediate attention or the procedure may be postponed for days or even weeks depending on the condition’s severity. Two major retinal detachment surgeries include: Vitrectomy: In this procedure, the surgeon removes the vitreous jelly, which has pulled on the retina and caused retinal detachment. Usually, the doctor then replaces the fluid with a gas bubble, which the eye, in time, will absorb and replace with its natural fluids. Doctors may recommend this surgery in instances where:

What is Diabetic Retinopathy?

Diabetic retinopathy is a condition where high blood sugars damage the blood vessels in the retina (the retina is the layer of cells in the back of the eye that transmit light to the brain to form images). There are two main types of diabetic retinopathy: non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR).

What is Retinal Vein Occlusion (RVO) and Macular Edema?

The retina is the light-sensing layer of cells that lines the inner wall of the back of the eye. The retina converts light into signals that are sent to the brain where they are recognized as images. What is Retinal Vein Occlusion? Your retinas require a rich supply of oxygenated blood. This blood is carried to the retina from the heart through arteries, while veins carry deoxygenated blood from the retina back to the heart via the optic nerves. The arteries that transport oxygen to your retina may stiffen and thicken over the years, especially in people with diabetes, cardiovascular disease, high blood pressure and high cholesterol. The retinal arteries and veins are close to the optic nerve and cross various locations on the retina’s surface. As arteries thicken, they can compress the retinal vein at artery-vein crossing points or in the optic nerve. This compression can be so severe that the veins become constricted and thus blood flow to the heart is reduced. The blood then backs up into the retina not unlike the water in a clogged bathtub. The pressure of blood in the veins causes swelling (called macular edema) and bleeding in the retina.

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Macular Hole

What is the Retina?

If the eye were a camera, the retina would be the film of that camera
The retina is a thin sheet of nerve cells that lines the inside back wall of the eye
Light travels through the eye and ultimately reaches photoreceptors, the light-sensitive cells in the retina
The signal from the photoreceptors then travel along the optic nerve to the brain, where the signals are interpreted as vision

retina2

What is the Macula?

The macula is the center region of the retina
The macula is responsible for high detail vision, central vision, reading, etc. The rest of the retina is responsible for peripheral vision.
AMD affects the macula, and in turn, results in decreased vision for tasks like reading, driving, recognizing faces, etc.

What is a Macular Hole?

A full-thickness defect (hole) in the macular region of the retina

Macular Hole Scan — Left image: Optical coherence tomography (OCT) scan through a normal, healthy retina. Notice the tissue is continuous with clear dark and light bands and a dip in the center signifying the foveal dip, responsible for crisp, clear vision. Right image: There is a full thickness defect, or hole, in the central retina (a gap in the tissue).

How does a macular hole affect vision?

Decrease in central vision
Dark spot in the middle of the vision
Missing letters when reading a word

What causes a macular hole?

Most macular holes are due to abnormalities in the aging process of the eye, whereby tractional forces pull on the fovea at the center of the macula and allow a hole to develop
Macular holes may also occur in eyes after trauma

How is a macular hole treated?

Full thickness macular holes may rarely close on their own. In very small macular holes with specific clinical features, a trial of eye drops may help facilitate closure.
Most full thickness macular holes, however, require surgery for closure

What is macular hole surgery?

Pars plana vitrectomy
Outpatient, day surgery
Micro-incisional surgery whereby the microscopic tissues creating traction on the retina are peeled gently from the fovea and removed. This relieves traction on the hole
A gas bubble is placed in the eye and patients typically maintain a face down position for several days to help support macular hole closure
Vision is poor through a gas bubble, but the gas will dissipate on its own, usually over 2-3 weeks (possibly longer if a longer acting gas bubble is used)
Left image: An optical coherence tomography (OCT) scan reveals a full thickness defect in the center due to macular hole. The patient’s vision is 20/200. Right image: An OCT image after surgical repair of the macular hole in the same patient shows closure of the macular hole. Vision improved to 20/40.

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Macular Hole

What is the Retina?

What is the Macula?

What is a Macular Hole?

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