Macular Pucker: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Macular Pucker?
An ophthalmologist, a medical doctor who treats eye disease and does eye surgery, usually treats macular pucker. A retina specialist, an ophthalmologist who focuses on the back of the eye, may do surgery if it is needed. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is macular pucker?
A macular pucker is an eye condition that can make your vision wavy or distorted. It is also called an epiretinal membrane or cellophane maculopathy.
It happens when a membrane, a thin layer of tissue, forms on the surface of the retina. The retina is the light-sensitive layer of tissue in the back of the eye.
The macula is the central part of the retina. It helps you see fine detail for reading and recognizing faces.
A macular pucker is not the same as age-related macular degeneration.
Symptoms
Many people have no symptoms at all. When symptoms start, they can include:
- Straight lines that look bent or wavy.
- Letters or words that are hard to read, missing, or crowded.
- Trouble seeing small details.
A macular pucker can slowly get worse. If it does, letters or objects may be so blurry that they are hard to see at all.
Macular pucker usually affects 1 eye. In rare cases, it can cause severe vision loss or lead to a macular hole.
Causes and who gets it
Most of the time, a macular pucker comes from normal changes in the eye as you get older. The vitreous is the clear gel that fills the eye. With age, it shrinks and pulls away from the retina. This is called a vitreous detachment.
A macular pucker can also follow other eye problems, such as a retinal tear or detachment or diabetic retinopathy. It can also follow eye surgery or inflammation inside the eye.
It can happen at any age, but your risk goes up as you get older. You may also be at higher risk if you have had:
- Floaters.
- A vitreous detachment.
- A retinal tear or retinal detachment.
- An eye injury, laser treatment, or eye surgery.
- Uveitis, which is inflammation in the eye.
Men and women are equally affected. In about 10% to 20% of cases, both eyes have a pucker.
How doctors diagnose it
Your eye doctor checks for a macular pucker during a dilated eye exam. The doctor puts in drops to widen your pupil and looks at the retina. The exam is simple and painless.
Your doctor may also do optical coherence tomography, or OCT. OCT uses light waves to take detailed pictures of your retina. It helps the doctor see how severe the pucker is.
Sometimes an additional test called fluorescein angiography is also used. It helps find other retina problems that may have caused the pucker.
Treatment
Most people with a macular pucker have mild symptoms and need no treatment. You will need regular eye exams to make sure it does not get worse. Your eye doctor might also suggest glasses or a new glasses prescription.
There are no eye drops, medicines, or supplements to treat it. In rare cases, the membrane lets go of the retina on its own.
If a pucker makes everyday tasks like reading or driving hard, you may need surgery. There are 2 types of surgery:
- Vitrectomy. The doctor removes the vitreous and then removes the membrane from the retina.
- Membranectomy. The doctor removes the membrane from the retina.
Surgery has a good success rate. Most people see better and have less wavy vision afterward.
Vision gets better slowly after a vitrectomy. Most eyes improve within 3 months, but it may take a year to reach the best vision.
Vitrectomy has risks. About 1 in 100 people develop a retinal detachment, and about 1 in 2000 get an infection. People who still have their natural lens will have increased progression of a cataract (clouding of the lens) in the eye that had surgery.
When to see a doctor
Tell your eye doctor if you notice any change in your vision. Talk to your eye doctor if reading or driving becomes hard.
If a macular pucker gets worse, letters or objects may be so blurry that you have a hard time seeing them at all. Tell your eye doctor if you notice any changes.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can check your symptoms, arrange a referral to an eye doctor, and help you keep up with follow-up visits.
Common questions
Is macular pucker the same as age-related macular degeneration?
No. They may have similar symptoms, but they are very different conditions.
Does macular pucker always need treatment?
No. Most people have mild symptoms and do not need treatment. Surgery is considered if it makes daily tasks like reading or driving hard.
Can eye drops treat macular pucker?
No. There are no eye drops, medicines, or supplements to treat it.
What causes macular pucker?
Most often it is a normal change that comes with aging. The vitreous gel shrinks and pulls away from the retina, and a membrane can form on the retina.
Can macular pucker cause severe vision loss?
Yes, but only in rare cases. Most people have mild symptoms.
Sources
- National Eye Institute - Macular Pucker
- American Society of Retina Specialists - Epiretinal Membranes
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
