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Your ophthalmologist has diagnosed
a macular pucker in your eye.
A macular pucker, also called an epiretinal membrane,
is a layer of scar tissue that grows on the surface
of the macula, which is the part of your eye
responsible for detailed central vision.
Your ophthalmologist has recommended
repairing your macular pucker with vitrectomy surgery.
This surgery can help
to prevent further retinal damage
and may save your remaining sight.
To understand how a macular pucker
affects your vision,
let's take a look at how the eye works.
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Light rays enter the eye
through the cornea, pupil, and lens.
These light rays are focused on the retina,
the light-sensitive tissue lining the back of the eye.
The retina has two areas:
the peripheral retina,
which gives us our side or wide-angle vision,
and the macula, the small area at the center of the retina.
The macula gives us our pinpoint vision,
allowing us to see detail clearly.
The inner eye is filled with a clear, jelly-like substance
called vitreous.
As we age, the vitreous becomes less like jelly
and more like liquid.
Usually, the vitreous is only loosely attached
to the retina, so as the eye moves,
the vitreous moves away from the macula
without causing problems.
In some cases, however, 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.
Your ophthalmologist will repair your macular pucker
with vitrectomy surgery.
This procedure is done in an operating room.
To perform a vitrectomy,
your ophthalmologist makes tiny incisions in the sclera,
or white of the eye.
Using microsurgery instruments,
your eye surgeon removes the wrinkled tissue
on your macula as well as the vitreous gel
that may be pulling on the macula.
Sometimes, an air or gas bubble is placed in the eye
to help the retina heal or to seal any tears or holes.
After the tissue is gone, the macula flattens
and vision slowly improves,
though it usually does not return
all the way to normal.
You may be told to keep your head
in a certain position while the bubble helps
hold the macular tissue in place.
It's important to follow
your ophthalmologist's instructions
so your eye will heal properly.
It can take up to three months
for your vision to fully recover
after macular pucker surgery.
On average, about half of the vision lost
from a macular pucker is restored,
though some people have
significantly more vision restored and some less.
In most cases, though, surgery significantly reduces
the visual distortion caused by macular pucker.
As with any procedure, there are risks of side effects
and complications with vitrectomy surgery
to repair a macular pucker.
These may include:
bleeding,
eye infection,
retinal detachment,
new or recurring scar tissue inside the eye,
clouding or scarring of the cornea,
clouding of the lens of the eye, or cataract,
a droopy eyelid,
increased pressure in the eye called glaucoma,
vision loss,
and the possible need for additional treatment
including medication and surgery.
Also, your eye problem could remain or get worse.
You do not have to be treated for your macular pucker.
However, if it is left untreated,
a macular pucker may lead to progressive
and irreversible loss of vision.
Be sure to keep all appointments
with your ophthalmologist after treatments.
Also, if you have any changes in your vision,
you should call your ophthalmologist right away.
Monitoring your vision is a vital step
toward the goal of preserving your sight.
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