Macular Pucker

Macular Pucker or Epiretinal Membrane

Laguna Hills Macular PuckerMacular 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.


The Retina Associates of Orange County 
If you live in Newport Beach macular pucker doctors are nearby. The Retina Associates of Orange County are licensed and certified ophthalmologists in California. Our multilingual staff (Tagalog, Korean, Chinese, Vietnamese, English, Farsi, and Spanish) helps clients of all ages and from different backgrounds. We see a broad range of eye problems including macular pucker. Guided by our knowledge, experience, and passion to enable people to improve their vision, we have a built a solid reputation. If you are in Newport Beach macular pucker consultations are just a phone call away.


Understanding the Macula
The retina is the light-sensing layer of cells that lines the inner wall of the back of the eye.  The macula is the center of the retina that allows one to see fine detail.  If you think of your eye like a camera, the retina and macula are the film of the camera.  There are many conditions that can damage the macula.
An epiretinal membrane is a condition with many names: macular pucker, pre-retinal fibrosis, cellophane maculopathy, and surface wrinkle retinopathy, among others. All of these allude to an ailment that causes blurred and/or distorted central vision.


What causes an epiretinal membrane or macular pucker?
The vitreous gel separates from the retina in nearly everyone at some point in his or her life.  In some people, when the vitreous separates, it causes scar tissue to form over the macula.  This extra tissue will often thicken and contract, causing an irregular surface of the macula layer.


What are the symptoms of an epiretinal membrane or macular pucker?
Some patients are without symptoms, but as the macular pucker or epiretinal membrane thickens, patients will often describe wavy lines or distorted central vision.  Blurred vision and/or difficulty reading may also be a symptom.


Macular Puckers versus Macular Holes
A macular pucker and macular hole are different conditions of the eye. Both result from a shrinking vitreous pulling on the retina. When this pulling leads to small microscopic damage, the retina can naturally heal itself, but the scar tissue that results can be considered a macular pucker. If the shrinking vitreous pulls on the retina too hard, a tear can result. Known as a macular hole, this is a more serious condition. Both issues present similar symptoms which is why you should see an ophthalmologist for an accurate diagnosis and proper treatment.


An ophthalmologist can examine your retina in order to diagnose an epiretinal membrane. Once the membrane is detected, there are two common photographic tests administered for assessing the extent of the damage to the underlying retina. These tests are fluorescein angiography (FA) and optical coherence tomography (OCT).


Fluorescein Angiography– in a in a fluorescein angiogram, patients are injected with sodium fluorescein dye through the veins in their hands or arms. Then the physician takes a series of photographs of the retina. The physician can use these photographs to evaluate the retinal layer, the layer beneath the retina and the retina’s blood vessels. The dye used in this process is not x-ray dye and no x-ray is taken. Rather, sodium fluorescein dye is a photographic dye that the patient will eventually eliminate from the body through urination. The dye may stain the patient’s skin yellow for up to 24 hours. The test is considered highly safe and effective. However, some patients may prove allergic to the dye. In this case, another kind of test, optical coherence tomography, may be administered.


Optical coherence tomography is a newer epiretinal membrane assessment in which light waves are bounced off the retina to obtain a cross section image. No dye is used in this exam. Rather, the light waves map the retina, acting similarly to sonar waves mapping images of the ocean floor.


Epiretinal Membrane Treatment
The only way known to treat epiretinal membranes is to surgically remove them. Surgery is generally not necessary in cases where symptoms are mild. If both eyes are affected, strengthening one’s bifocals or using a magnifying glass may improve one’s near vision.


In more substantial cases, the membrane is removed in a procedure known as vitrectomy. This is generally an outpatient procedure in which local anesthesia is administered. Surgeons in this procedure use minute instruments to remove the vitreous humor from the eye’s central cavity and then remove the membrane that wrinkles the macula. After which, the macula should smooth out and symptoms will gradually be reduced. Most patients see an improvement in vision following this treatment. However, vision usually does not return to normal, and some visual distortion and reduced acuity often remain.


As with any surgery, there are risks.  In vitrectomy surgery, the risks include infection, bleeding, torn or detached retina, inflammation, or affects to the blood vessels in the retina.


How successful is Newport Beach macular pucker surgery?
Repairing a macular pucker with a surgical procedure is a delicate process. In most cases the vision will improve; however, sometimes it does not return to normal. Every patient is different; some will see a large improvement and others only slightly. That being said, the majority of patients will see an improvement in vision distortion. Recovery can take three months or more. It’s important to follow any recommended post surgical treatment for optimal outcomes.


Other Conditions of the Eye in Conjunction with Macular Pucker
When you visit Newport Beach macular pucker doctors, you may also be examined for additional diseases of the eye. Oftentimes, patients with macular pucker will have other eye problems including cataracts, macular edema, or retinal vein occlusion. If any of these issues are discovered, a treatment plan will be devised that includes each problem. Some can be addressed and treated simultaneously and others will need to be individually treated when the time is right. Your ophthalmologist can discuss all of your options during your eye appointments. Rest assured that when you are a patient of the Retina Associates of Orange County, you will be in good hands.


Contact Us Today For Treatment of Macular Pucker or Epiretinal Membrane
If you suspect you are suffering from visual distortion caused by epiretinal membranes, contact Retina Associates of Orange County. Our qualified retinal specialists can help restore your sight and/or prevent further vision loss.


Whether you are in Santa Ana, Laguna Hills, or Newport Beach macular pucker doctors can help you correct and restore your vision; call us at 949-706-3514 for a free consultation.

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