Causes
An epiretinal membrane or cellophane maculopathy occurs when a thin layer of scar tissue forms on the macula, the central part of the retina that provides sharp, detailed vision.
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The vitreous gel can pull away from the retina as the eye ages, causing scar tissue to form.
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Scar tissue can grow on the macula after retinal tears or detachments.
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Uveitis, for example, can cause inflammation and scarring on the retina.
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The macula can develop scar tissue due to diabetic retinopathy.
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Surgery or trauma to the eye can lead to the development of a macular pucker.
Symptoms
Symptoms of a macular pucker can vary in severity and may affect either eye. Common symptoms include:
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Vision distortion: Straight lines may appear wavy or bent.
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Inability to see fine details, read, or recognize faces due to blurry central vision.
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Cloudy or gray patch in the central vision.
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The sharpness of vision generally declines with decreased visual acuity.
Diagnosis
There are several steps and diagnostic tools involved in diagnosing a macular pucker:
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An eye exam that includes dilation to view the retina is referred to as a comprehensive eye exam.
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A macular pucker can be identified precisely by using optical coherence tomography (OCT), an imaging test that provides detailed cross-sectional images of the retina.
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A dye is injected into the bloodstream to highlight blood vessels in the retina and identify abnormalities.
Treatment
Macular puckers are treated according to the severity of symptoms and their impact on daily life. Options include:
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Mild cases with minimal symptoms may be monitored over time without immediate treatment.
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A vitrectomy involves removing the vitreous gel and scar tissue from the macula. This can improve vision and reduce distortion.
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Patients may need to follow specific postoperative instructions, such as avoiding certain activities and using prescribed eye drops to promote healing.
Prevention
Certain measures can reduce the risk of macular pucker, even though it may not be possible to prevent all cases:
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Eye exams: Routine eye exams can detect early signs of retinal conditions and address them as soon as possible.
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Eye protection: Wearing protective eyewear during activities that pose a risk of eye injury.
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Managing underlying conditions: Controlling diabetes, high blood pressure, and other conditions that can affect eyesight.
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Maintaining a healthy lifestyle, such as eating a balanced diet, exercising regularly, and not smoking, will support the health of your eyes.
Conclusion
There are many causes of macular pucker, including aging, retinal tears or detachments, inflammation of the eye, diabetes, and eye surgery or trauma. It is caused by scar tissue forming on the macula. A comprehensive eye examination, OCT imaging, and possibly fluorescein angiography are used to diagnose this condition, which consists of distorted vision, blurry central vision, and gray or cloudy areas. Preventative measures include regular eye exams, protecting the eyes, managing underlying conditions, and maintaining a healthy lifestyle. Treatment options include observation and vitrectomy surgery.
