The center of your retina, called the macula, is responsible for the sharp, detailed vision you need for reading, driving, and recognizing faces. When problems develop in this area, they can significantly affect your quality of life.
Two common conditions that affect the macula are macular pucker and macular hole. At Inland Valley Retina, our board-certified retina specialists have extensive experience diagnosing and treating these conditions using advanced technology and proven surgical techniques.
While both conditions affect the macula and can cause similar visual symptoms, they are distinctly different problems that require specific approaches to treatment. A macular pucker, also called an epiretinal membrane, occurs when scar tissue forms on the surface of the macula.
As this tissue contracts and tightens, it causes the macula to wrinkle, distorting your vision. Think of it like a wrinkle in a piece of fabric; the underlying structure remains intact, but the surface becomes uneven.
A macular hole, on the other hand, is an actual opening or defect in the center of the macula. This happens when the vitreous gel inside your eye pulls away from the retina with enough force to tear the macular tissue, creating a hole.
As the hole enlarges, it can cause progressively worsening central vision loss.
Both macular pucker and macular hole typically develop as part of the natural aging process. This is because the vitreous gel that fills your eye can become more liquid as you get older and may pull away from the retina in a process called posterior vitreous detachment.
Small particles in the vitreous may also settle on the macula’s surface and gradually transform into scar tissue, resulting in a macular pucker. You may be at higher risk for developing macular pucker or macular hole if you have experienced eye trauma, inflammation inside the eye, a retinal tear or detachment, diabetic retinopathy, or if you are very nearsighted.
Macular holes are more common in women and typically occur after age 55.
The symptoms of macular pucker and macular hole can be similar, particularly in the early stages of development. You may notice that straight lines appear wavy or bent, a condition known as metamorphopsia.
Reading may become difficult as letters seem distorted or crowded together. Your central vision may seem blurry, even with corrective lenses.
As a macular hole progresses, you may develop a dark or blank spot in the center of your vision. This can make it difficult to perform tasks that require fine detail, like threading a needle or seeing faces clearly.
Many people with a macular hole in only one eye don’t realize they have a problem at first because their other eye compensates for the vision loss. Macular pucker symptoms are often milder and may remain stable for years.
Some people adapt to the visual changes, while others find the distortion increasingly bothersome over time. If you notice any changes in your vision, particularly wavy lines or a dark spot in your central vision, schedule an appointment with your retina specialist at Inland Valley Retina right away.
Early diagnosis can lead to better treatment outcomes.
Inland Valley Retina uses advanced diagnostic technology to accurately identify and assess macular pucker and macular hole. During your comprehensive eye examination, your eye doctor will dilate your pupils to examine the retina in detail.
Optical coherence tomography (OCT) is a key diagnostic tool that creates high-resolution, cross-sectional images of your retina. This non-invasive imaging technique allows your retina specialist to visualize the layers of your retina, measure the size of a macular hole, and assess the extent of membrane formation in a macular pucker.
Your doctor may also use an Amsler grid, a simple test that can reveal subtle visual distortions you might not have noticed. In some cases, fluorescein angiography may be performed to evaluate blood flow in the retina and rule out other conditions that can cause similar symptoms.
Treatment decisions depend on the severity of your symptoms, the size and location of the condition, and the extent to which your vision is affected.
When macular pucker or macular hole significantly affects your ability to perform daily activities, surgery offers the best chance for visual improvement. Vitrectomy is the primary surgical treatment for both conditions.
During this outpatient procedure, performed under local anesthesia with mild sedation, your retina specialist removes the vitreous gel from your eye. For macular pucker, the surgeon carefully peels away the scar tissue membrane from the macula’s surface.
For a macular hole, the surgeon may also peel a very thin layer called the internal limiting membrane to help promote hole closure. After removing the tissue, the surgeon injects a special gas bubble into the eye.
This gas bubble acts as an internal bandage, applying gentle pressure to help the macular tissue heal properly. The gas bubble gradually dissolves and is replaced by your eye’s natural fluid over several weeks.
More than 90% of macular holes close successfully after vitrectomy, particularly when the hole is smaller and treated earlier. Most patients with macular pucker experience significant improvement in vision distortion after membrane removal.
While laser treatments and retinal injections are not primary treatments for macular pucker or macular hole, they may be used in specific situations or to address related conditions. Your retina specialist will determine if these treatments are appropriate based on your complete eye health evaluation.
Inland Valley Retina’s approach to treating macular conditions reflects our commitment to comprehensive, compassionate patient care. Our board-certified physicians specialize exclusively in diseases and surgery of the retina and vitreous.
This focused expertise enables us to stay current with the latest research and most advanced treatment techniques for conditions such as macular pucker and macular hole. Our practice is equipped with state-of-the-art diagnostic technology, including high-resolution optical coherence tomography, allowing for precise diagnosis and treatment planning.
Most importantly, we treat every patient with compassion and respect. Our experienced Ophthalmic Assistants and physicians work together to create a courteous, professional environment where you feel heard and supported throughout your treatment journey.
If you’re experiencing vision changes, such as blurry or distorted central vision, or difficulty with reading and performing detailed tasks, don’t wait to seek an evaluation. Early diagnosis and timely treatment of macular conditions can help preserve your vision and maintain your quality of life.
Schedule a comprehensive retinal examination at Inland Valley Retina in Corona, Menifee, or Temecula, CA, today!
You’ll see that when it’s time to make an appointment with a specialist in Retina and Vitreous diseases, you can trust your eye health to the team at Inland Valley Retina Medical Associates, Inc.
If you would like to speak with the Administrator, Please contact Sandra Aguirre.
Phone: 951.679.0400
Fax: 951.672.6667