Macular Conditions (Macular Hole & Macular Pucker)
At Illinois Retina Associates, we treat the full spectrum of disorders affecting the retina. This thin tissue layer performs the vital role of converting light into electrical signals that speed along the optic nerve to the brain, where they transform into images, enabling sight. Our central vision (i.e., the part of our visual field that corresponds with the highest visual acuity and detail perception) is governed by the central portion of the retina known as the macula, which contains a high concentration of cone cells (i.e., photoreceptor cells responsible for color vision and visual acuity). Damage to the macula can be considered serious, causing distorted vision and other issues.
What Is a Macular Hole?
A common condition is a macular hole, which is, as its name suggests, a hole developing in the macula. Typically formed due to macular stretching or pulling, macular holes can disrupt your central vision while leaving peripheral vision intact.
What Are Macular Puckers and Epiretinal Membranes?
Macular puckers, also referred to as epiretinal membranes, is a condition in which a thin, semi-transparent scar tissue layer grows over the macula, making it difficult to see. This scar tissue may eventually spread and contract, making the retina very wrinkled or “puckered.”
Symptoms of Macular Holes and Macular Puckers
Macular holes and puckers can affect your central vision, impacting activities like reading, driving, and recognizing faces. Macular holes typically occur at the center of the macula, called the fovea, which is responsible for sharp vision. Initially, a small blurry or distorted area may appear in your central vision, and over time, the hole can grow and further disrupt your central vision. Peripheral vision is usually unaffected. In rare cases, a macular hole can lead to retinal detachment, a serious condition that requires immediate medical attention. Retinal detachment causes blurriness and, if untreated, can result in vision loss.
Macular puckers can cause difficulty in clear vision as scar tissue develops and clouds your vision, gradually narrowing your field of view. Macular puckers can affect anyone, including those without previous eye or vision issues, and may indicate an underlying eye disease or trauma.
While some people with macular holes or puckers may not experience vision problems, especially if their other eye is healthy, others may have distorted and blurred vision. Although rare, a macular pucker can develop into a macular hole.
Causes and Risk Factors of Macular Holes and Macular Puckers
For both macular concerns, the most common risk factor is age, especially if a patient has posterior vitreous detachment (PVD). With this common condition, the vitreous, a clear gel that fills most of the eye and maintains its shape, shrinks and diminishes in thickness with age. For some, the vitreous may become extra sticky, attaching to the retina. The vitreous then shrinks away, pulling on the retina, and causing damage to the macular tissue.
Both macular holes and puckers are more likely to occur with certain eye conditions, including severe myopia, retinal tears, and diabetic retinopathy. Macular holes can also sometimes be caused by eye injuries or trauma, while macular puckers can form after a previous eye surgery (such as cataract surgery).
If you’re over the age of 60 years old, you may be at higher risk for the development of macular holes, macular puckers, and age-related macular degeneration (AMD). However, beyond having similar symptoms, these conditions are unique, with each requiring its own diagnosis from an ophthalmologist or retina specialist.
Generally, as your vision is unaffected, macular holes and macular puckers may not require treatment. You can expect regular follow-up appointments to monitor your macular health. However, in some cases, surgery may be necessary.
Macular holes that result in vision problems may require a surgical procedure to repair the hole and prevent permanent vision loss. Known as a vitrectomy, the procedure involves the vitreous’ complete removal from the eye. A surgeon injects your eye with a gas bubble, serving as a temporary bandage to hold the hole’s edges together, helping it to close.
For a macular pucker, in the event your central vision is affected, a vitrectomy may be performed. Another option is a safe, quick (taking less than 30 minutes), in-office procedure called a membranectomy, in which a surgeon removes the membrane from your retina. Your ophthalmologist may also advise that you wear eyeglasses or update your current prescription to improve your vision.
Advanced Care for Macular Holes, Macular Puckers, and Epiretinal Membranes in Illinois and Indiana
Illinois Retina Associates is a leading retina-only ophthalmology practice in the Midwest devoted to diagnosing and treating macular disorders, including macular holes, macular puckers, and epiretinal membranes. When you or a loved one visit our retina centers, rest assured that our experienced retina specialists and surgeons will develop a personalized treatment plan to ensure your recovery. Contact one of our 12 convenient locations today to schedule a consultation.