Is Macular Pucker Equivalent to Age-Related Macular Degeneration?
Macular pucker is not age-related macular degeneration. However, because they both affect the macula, they have overlapping symptoms. For example, in both cases, patients report wavy, blurry vision in the center of their visual field. But unlike AMD, which often develops in both eyes simultaneously, macular pucker doesn’t have any preference for developing in one or both eyes.
A retinal ophthalmologist is a medical specialist with the expertise to treat macular pucker. Macular pucker treatment is different from AMD treatment. Macular degeneration is treated medically, while macular pucker is treated surgically.
What Is the Difference Between A Macular Pucker and A Macular Hole?
In both conditions, patients have shared symptoms such as blurry and distorted vision. Both macular pucker and macular hole result when the vitreous contracts and pulls on the retina.
Even so, a macular pucker is not the same as a macular hole. The latter is a break or ‘hole’ in the macula that results when dynamic vitreous contraction tears the retina. In other words, a macular hole occurs when forces on the retina pull it apart, while macular pucker tends to draw the retina together.
What Are the Signs of Macular Pucker?
If you notice that the center of your vision is blurry or lines are wavy when reading a book, you may have a macular pucker. You may experience issues in seeing fine detail and reading small fonts. In some instances, there is a blurry spot or a gray area in your central vision.
Please note that these symptoms may indicate something else, including AMD and macular holes. Visit an eye MD for an accurate diagnosis and comprehensive macular pucker treatment. The ophthalmologist will conduct a dilated eye exam or take advanced imaging of your retina via optical coherence tomography (OCT).
What Can You Do for Macular Pucker?
Observe: In many cases of confirmed macular pucker diagnosis, the condition is mild. If it doesn’t severely impact vision, the doctor may choose to leave it alone.
Surgery: For severe and advanced macular pucker cases, the condition can be treated with surgical removal of the membrane.
Is there any treatment for macular pucker?
Depending on the diagnosis, your doctor may suggest not treating macular pucker. Even so, expect a recommendation for regular eye checkups as the specialist will need to track the condition. For medium to high severity cases, they may prescribe surgical intervention.
Surgery for Macular Pucker
Besides observation, surgery is the only option in macular pucker treatment. The procedure for macular pucker is usually performed under local anesthesia. You’ll be awake through it, but you won’t feel pain.
The first part of the medical procedure includes removing the vitreous gel that fills the eye. This step is called a vitrectomy. The surgeon will use small instruments to cut the vitreous and remove it. The tools used to make the incisions usually are about half a millimeter wide. Removal of the vitreous gel can help eliminate retinal tugging or provide better access to the retina to remove scar tissue.
Next comes the stripping off of the cellophane-like scar tissue. The specialist will eliminate the epiretinal membranes that are causing the macular pucker. This will allow the macula to relax back to its normal shape against the back of the eye for good vision.
What happens during a macular pucker surgery?
- It’s an outpatient procedure done in an ambulatory surgical center.
- Vitals are monitored using oxygen, blood pressure, IV, and EKG sensors.
- The eye is numbed, and IV sedation may be used for patient comfort.
- The eye is cleaned with antiseptic, and the eyelid is kept wide open with a speculum.
- A surgical microscope is used to magnify the view
- Instruments are inserted through the ‘safe zone’ white part of the eye.
- The retina specialist uses a vitrector to remove the vitreous delicately.
- The eye is filled with vitreous substitutes, usually, a form of saline called “balanced salt solution”.