Macular pucker, also known as epiretinal membrane or macular gliosis, is the formation of wrinkles, creases or bulging on the macula.

Symptoms:
Symptoms of macular pucker range from mild to severe and may involve one or both eyes and peripheral vision is not affected. These symptoms include:

• blurred central (detail) vision;
• distorted or wavy vision;
• difficulty reading or performing tasks that require detail vision;
• gray or cloudy area in central vision;
• central blind spot.

Causes:
With aging, the vitreous gel inside the eye begins to shrink and pull away from the retina. As the vitreous pulls away, scar tissue may develop on the macula. Sometimes the scar tissue can warp and contract, causing the retina to wrinkle or bulge.

Treatment:
For mild symptoms, no treatment may be necessary. Updating the eyeglass prescription or wearing bifocals may improve vision. Eyedrops, medicines or laser surgery do not improve vision.

For more severe symptoms, a surgery called vitrectomy is recommend. The surgery is usually performed as an inpatient procedure in a hospital or surgical center. During surgery, the ophthalmologist uses tiny instruments to remove the wrinkled tissue on the macula. After the tissue is gone, the macula flattens and vision slowly improves, though it usually does not return all the way to normal.

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